Endophthalmitis in aphakic patients with unplanned filtering blebs wearing contact lenses.

Four female patients with known unplanned filtering blebs following cataract surgery developed endophthalmitis, two weeks to 30 months after being fit with corneal contact lenses. Three patients were wearing hard contact lenses and one wore a soft lens. Significant blepharoconjunctivitis was present and treated in two patients, but intraocular infection was not averted. When endophthalmitis was diagnosed, all patients had clinical evidence of a bleb infection as well as hypopyon. Despite aggressive medical therapy, two eyes required enucleation while two eyes survived with good vision. We recommend that eyes that have unplanned filtering blebs following cataract surgery should not have a contact lens inserted until the blebs have been closed.