A case of endophthalmitis following needling procedure after PRESERFLO^® Micro Shunt implantation

To report a case of endophthalmitis following bleb needling in a patient previously implanted with a PRESERFLO^® MicroShunt.

Case report.

A 40-year-old woman with bilateral malformative glaucoma repeatedly operated on in childhood underwent PRESERFLO^® MicroShunt implantation in her right eye and six needling revisions (NRs) and a surgical revision due to unsatisfactory intraocular pressure (IOP) control due to bleb encapsulation. About 3 months after the surgical revision the bleb encapsulation relapsed and she underwent a further NR with betamethasone. About 4 days after the last NR, she experienced visual acuity reduction and was therefore advised to come immediately to the hospital for an unscheduled visit, showing up with hypopyon and diffuse vitreous haze. A clinical diagnosis of endophthalmitis (later confirmed by bacteria culture tests) was made and she was treated with pars-plana vitrectomy with silicone oil and intravitreal antibiotics. Preoperative visual function was luckily completely restored.

Endophthalmitis can occur after NR in an eye with PRESERFLO^® MicroShunt implant which therefore does not prevent reflux of bacteria from a filtering bleb to the anterior chamber.