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. 2023 Sep:253:37-43.
doi: 10.1016/j.ajo.2023.04.006. Epub 2023 Apr 13.

Endophthalmitis Associated With XEN Stent Implantation

Benjamin R Lin  1 , Hasenin Al-Khersan  1 , Elena Bitrian  1 , Harry W Flynn Jr  2
Affiliations

Endophthalmitis Associated With XEN Stent Implantation

Benjamin R Lin et al. Am J Ophthalmol. 2023 Sep.

Abstract

Purpose: The aim of this study is to report the clinical characteristics, causative organisms, and treatment outcomes in patients presenting with endophthalmitis related to XEN stent implants.

Design: Retrospective, noncomparative consecutive case series.

Methods: Clinical and microbiologic review was performed for 8 patients presenting to the Bascom Palmer Eye Institute Emergency Room between 2021 and 2022 with XEN stent-related endophthalmitis. Data collected included clinical characteristics of patients at presentation, organisms identified in ocular cultures, treatments received, and visual acuity at last follow-up.

Results: The current study included 8 eyes from 8 patients. All cases of endophthalmitis occurred >30 days after implantation of the XEN stent. At the time of presentation, there were external exposures of the XEN stent in 4 of 8 patients. Five of the 8 patients had positive intraocular cultures, all of which were variants of staphylococcus and streptococcus species. Management included intravitreal antibiotics in all patients, explantation of the XEN stent in 5 patients (62.5%), and pars plana vitrectomy in 6 patients (75%). At last follow-up, 6 of the 8 patients (75%) had a visual acuity of hand motion or worse.

Conclusions: Endophthalmitis in the setting of XEN stents results in poor visual outcomes. The most common causative organisms are staphylococcus or streptococcus species. At time of diagnosis, prompt treatment with broad-spectrum intravitreal antibiotics is recommended. Consideration can be made to explant the XEN stent and perform early pars plana vitrectomy.

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Conflict of interest statement

Conflict of Interest: No conflicting relationship exists for any author

Figures

Figure 1.
Figure 1.
Slit lamp photo of case two that presented with endophthalmitis in the setting of a XEN stent. There is significant purulence and the stent can be seen superonasally (arrow). Immediately superior to the stent, there is erosion of the conjunctiva and Tenon’s capsule down to bare sclera.
See this image and copyright information in PMC

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