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.
Methods :
Clinical and microbiological review was performed for eight patients presenting to the Bascom Palmer Eye Institute Emergency Room from 2021 to 2022 with XEN stent related endophthalmitis. Data collected includes 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 eight eyes from eight patients. All cases of endophthalmitis occurred greater than 30 days after implantation of the XEN stent. At time of presentation, there was external exposure of the XEN stent in four out of the eight patients. Five of the eight 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 five patients (62.5%), and pars plana vitrectomy in six patients (75%). At last follow-up, six of the eight 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. Visual acuity outcomes are generally poor in these patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.