title: Endophthalmitis With Corneal Infiltrate After EX-PRESS Glaucoma Drainage Device Implantation.
abstract: OBJECTIVE
  To report a case of endophthalmitis occurring shortly after EX-PRESS implantation with the formation of a corneal infiltrate overlying the EX-PRESS, requiring device removal for adequate treatment.
  
  
  METHODS
  This is a case report of a 56-year-old male with uncontrolled open-angle glaucoma who underwent right eye EX-PRESS implantation under a partial-thickness scleral flap with intraoperative application of mitomycin C.
  
  
  RESULTS
  On postoperative day 16, the patient was found to have bleb-associated endophthalmitis with a corneal infiltrate adjacent to the bleb and overlying the EX-PRESS. Two days after pars plana vitrectomy with injection of intravitreal antibiotics, the corneal infiltrate was enlarging and centered on the distal end of the EX-PRESS, while the back plate of the device became partially exposed. Clinical improvement was not achieved until the device was removed and the original surgical site was reinforced with a patch graft. By week 10 after device removal, intraocular pressure was 8 mm Hg and the corneal infiltrate had resolved into an opaque, partially vascularized scar.
  
  
  CONCLUSIONS
  Endophthalmitis after EX-PRESS implantation may be complicated by corneal infiltrate formation and persistent infection. Clinicians should monitor for these complications in the management of infection after EX-PRESS implantation and consider early device removal to achieve resolution.
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Cherof
authors.forename: Jeffery R
authors.initials: JR
authors.lastname: SooHoo
authors.forename: Malik Y
authors.initials: MY
authors.lastname: Kahook
authors.forename: Leonard K
authors.initials: LK
authors.lastname: Seibold
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003316:Corneal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020878:Device Removal; D004338:Drug Combinations; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D024841:Fluoroquinolones / Q000627:therapeutic use; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D000077266:Moxifloxacin; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D000477:Alkylating Agents; D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D024841:Fluoroquinolones; D005938:Glucocorticoids; D016685:Mitomycin; D011239:Prednisolone; D000077266:Moxifloxacin