Endophthalmitis Associated With XEN Stent Implantation.

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• XEN stent implantation is a surgical procedure to manage glaucoma.
• Endophthalmitis is a serious intraocular infection that can occur after ocular surgery.

Purpose of the Study:

• To describe the clinical features, identify the causative microorganisms, and evaluate treatment outcomes in patients with endophthalmitis after XEN stent implantation.

Main Methods:

• A retrospective case series of 8 patients with XEN stent-related endophthalmitis treated at Bascom Palmer Eye Institute between 2021 and 2022.
• Data included patient demographics, clinical presentation, microbiological cultures, treatments administered, and visual acuity outcomes.

Main Results:

• All 8 cases of endophthalmitis occurred more than 30 days post-implantation.
• Staphylococcus and Streptococcus species were the most common pathogens identified in positive cultures (5/8 patients).
• Treatment involved intravitreal antibiotics (all patients), XEN stent explantation (62.5%), and pars plana vitrectomy (75%). Visual acuity remained poor (hand motion or worse) in 75% of patients at last follow-up.

Conclusions:

• XEN stent-related endophthalmitis is associated with poor visual prognosis.
• Prompt administration of broad-spectrum intravitreal antibiotics is recommended.
• Early consideration for XEN stent explantation and pars plana vitrectomy may be beneficial.