A patient presented with eye pain and worsening vision 1.5 months after cataract surgery. Exam revealed purulent discharge, severe anterior chamber inflammation, and a XEN stent with nearby erosion of conjunctiva and Tenon’s down to bare sclera. Cultures were positive for streptococcus mitis/oralis. The patient was treated initially with a vitreous biopsy and intravitreal antibiotics. While they improved clinically initially with injections alone, ultrasound later revealed a possible retinal detachment and the patient was taken to surgery for XEN stent explantation and pars plana vitrectomy. Intraoperatively, membranes were identified but no retinal detachment was present. The final visual acuity was hand motion. XEN stent related endophthalmitis, like other etiologies of endophthalmitis can have devastating visual outcomes. Prompt treatment with a vitreous biopsy and injection of intravitreal antibiotics is beneficial. Similar to other etiologies of glaucoma tube shunt related endophthalmitis, consideration should be given towards removal of the stent and early vitrectomy.
Presentation Date: 10/27/2022
Issue Date: 12/09/2022
Continuing Medical Education (CME)