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与 XEN 支架植入相关的眼内炎。

Endophthalmitis Associated With XEN Stent Implantation.

机构信息

From the Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USA.

From the Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USA..

出版信息

Am J Ophthalmol. 2023 Sep;253:37-43. doi: 10.1016/j.ajo.2023.04.006. Epub 2023 Apr 13.

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.

DESIGN

Retrospective, noncomparative consecutive case series.

METHODS

Clinical and microbiologic review was performed for 8 patients presenting to the Bascom Palmer Eye Institute Emergency Room between 2021 and 2022 with XEN stent-related endophthalmitis. Data collected included 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 8 eyes from 8 patients. All cases of endophthalmitis occurred >30 days after implantation of the XEN stent. At the time of presentation, there were external exposures of the XEN stent in 4 of 8 patients. Five of the 8 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 5 patients (62.5%), and pars plana vitrectomy in 6 patients (75%). At last follow-up, 6 of the 8 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.

摘要

目的

本研究旨在报告与 XEN 支架植入相关的眼内炎患者的临床特征、病原体和治疗结果。

设计

回顾性、非对照连续病例系列。

方法

对 2021 年至 2022 年期间在 Bascom Palmer 眼科研究所急诊室就诊的 8 例与 XEN 支架相关的眼内炎患者进行临床和微生物学回顾。收集的数据包括患者就诊时的临床特征、眼部培养物中鉴定的病原体、接受的治疗以及最后一次随访时的视力。

结果

本研究包括 8 例 8 只眼。所有眼内炎病例均发生在 XEN 支架植入后>30 天。在就诊时,有 4 例 8 例患者的 XEN 支架有外部暴露。8 例患者中有 5 例的眼内培养物呈阳性,均为葡萄球菌和链球菌属的变异株。所有患者均接受了玻璃体腔内抗生素治疗,5 例(62.5%)患者行 XEN 支架取出术,6 例(75%)患者行玻璃体切割术。在最后一次随访时,8 例患者中有 6 例(75%)的视力为手动或更差。

结论

XEN 支架引起的眼内炎导致视力预后不良。最常见的病原体是葡萄球菌或链球菌属。在诊断时,建议立即使用广谱玻璃体腔内抗生素进行治疗。可以考虑取出 XEN 支架并尽早行玻璃体切割术。

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