Late endophthalmitis associated with glaucoma drainage implants

Objective: To report the clinical course of a series of patients who had la te endophthalmitis develop after glaucoma drainage implant (GDI) surgery. Design: Noncomparative, interventional, consecutive case series. Participants: Four patients were identified with late endophthalmitis assoc iated with Baerveldt glaucoma implants. Methods: The medical records of all patients with endophthalmitis associate d with a GDI treated at the Bascom Palmer Eye Institute or University of Fl orida between January 1, 1987 and December 31, 1999 were retrospectively re viewed. Patients with culture-positive endophthalmitis diagnosed more than 1 month after GDI surgery were included in this series. Main Outcome Measures: Visual acuity and intraocular pressure (IOP). Results: Late endophthalmitis associated with Baerveldt glaucoma implants d eveloped 7 weeks to 2 years postoperatively. Exposure of the GDI tube was p resent in all cases. The implant was removed in three of four patients. Vis ual acuity worsened from preinfection level in two of four cases. IOP was c ontrolled at last follow-up in all patients, although replacement of the ex planted GDI was required in one patient. Conclusions: Late endophthalmitis may occur after GDI surgery, Exposure of the GDI tube seems to represent a major risk factor for these infections. T o prevent this potentially devastating complication, we recommend prophylac tic surgical revision with a patch graft in all cases in which there is an exposed GDI tube. Ophthalmology 2001;108:1323-1327 (C) 2001 by the American Academy of Ophthalmology.