Bleb 相关性 Xen 凝胶支架眼内炎：病例报告及文献复习。
Bleb Associated Xen Gel Stent Endophthalmitis: A Case Report and Review of Literature.
机构信息
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Ophthalmology, Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
Ocul Immunol Inflamm. 2023 Sep;31(7):1533-1536. doi: 10.1080/09273948.2022.2093225. Epub 2022 Jul 25.
PURPOSE
To report a case of a unique late complication of the Xen gel stent, stent-related endophthalmitis was preceded by flattening of the bleb.
CASE REPORT
A 63-year-old female was presented with late-onset endophthalmitis preceded by flattening of the bleb two years post-insertion of Xen gel stent. B-scan of the posterior chamber revealed vitritis and hyaloid condensation, with no viral, fungal, or bacterial pathologies identified on anterior chamber tap. The patient's eye responded to injections of intravitreal antibiotics.
CONCLUSION
Endophthalmitis can occur as late as 2 years after implantation of glaucoma drainage device implants (GDIs) like the Xen gel stent if bleb flattening or leaking leads to contact of the stent with the conjunctiva. Therefore, in case of blebs getting flat, ophthalmologists should watch them more often. Intravitreal antibiotics may also be effective rather than surgical removal in the case of a non-eroded stent complicated by endophthalmitis.
目的
报告一例 Xen 凝胶支架的独特迟发性并发症，支架相关眼内炎发生在前房滤过泡变平之后。
病例报告
一名 63 岁女性，在 Xen 凝胶支架植入两年后出现迟发性眼内炎，此前房滤过泡变平。后房 B 超显示眼内炎和玻璃体液浓缩，但在前房抽吸时未发现病毒、真菌或细菌病理学改变。患者的眼睛对玻璃体内注射抗生素有反应。
结论
如果房水滤过泡变平或渗漏导致支架与结膜接触，青光眼引流装置（GDI）植入物（如 Xen 凝胶支架）植入后 2 年也可能发生眼内炎。因此，在房水滤过泡变平时，眼科医生应更频繁地观察它们。对于伴有眼内炎的未侵蚀支架，玻璃体内注射抗生素可能比手术切除更有效。
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