Pathologic findings in late endophthalmitis after glaucoma filtering surgery

Objective: To report the clinicopathologic features of four eyes enucleated for late-onset bleb-related endophthalmitis. Study Design: Retrospective case series. Materials: Four enucleated eyes. Methods: The clinical and histopathologic features of four patients who und erwent enucleation for late-onset endophthalmitis after glaucoma filtering surgery were reviewed. Results: The eyes were enucleated for endophthalmitis one to five years aft er trabeculectomy. Two of the four eyes had trabeculectomy with adjunctive mitomycin-C. All four eyes had streptococci cultured from the aqueous and/o r vitreous. Common pathologic features included inflammation involving the anterior segment, lens and choroid. One eye exhibited focal granulomatous u veitis. Conclusions: Late-onset endophthalmitis after glaucoma filtering surgery is often due to streptococcal species and rapidly progresses over a few days. Phacoanaphylaxis with associated granulomatous uveitis may contribute to t he poor prognosis in this setting. Ophthalmology 2000;107:2111-2114 (C) 200 0 by the American Academy of Ophthalmology.