Late endophthalmitis associated with glaucoma drainage implants.
OBJECTIVE
To report the clinical course of a series of patients who had late endophthalmitis develop after glaucoma drainage implant (GDI) surgery.


METHODS
Noncomparative, interventional, consecutive case series.


METHODS
Four patients were identified with late endophthalmitis associated with Baerveldt glaucoma implants.


METHODS
The medical records of all patients with endophthalmitis associated with a GDI treated at the Bascom Palmer Eye Institute or University of Florida between January 1, 1987 and December 31, 1999 were retrospectively reviewed. Patients with culture-positive endophthalmitis diagnosed more than 1 month after GDI surgery were included in this series.


METHODS
Visual acuity and intraocular pressure (IOP).


RESULTS
Late endophthalmitis associated with Baerveldt glaucoma implants developed 7 weeks to 2 years postoperatively. Exposure of the GDI tube was present in all cases. The implant was removed in three of four patients. Visual acuity worsened from preinfection level in two of four cases. IOP was controlled at last follow-up in all patients, although replacement of the explanted GDI was required in one patient.


CONCLUSIONS
Late endophthalmitis may occur after GDI surgery. Exposure of the GDI tube seems to represent a major risk factor for these infections. To prevent this potentially devastating complication, we recommend prophylactic surgical revision with a patch graft in all cases in which there is an exposed GDI tube.
Gedde
S J
SJ
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.
Scott
I U
IU
Tabandeh
H
H
Luu
K K
KK
Budenz
D L
DL
Greenfield
D S
DS
Flynn
H W
HW
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D020878:Device Removal; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D008297:Male; D016926:Mycobacterium chelonae / Q000302:isolation & purification; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012086:Reoperation; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014792:Visual Acuity
D000900:Anti-Bacterial Agents