Endophthalmitis Associated with XEN Stent Implantation.

PURPOSE: The aim of this study is to report the clinical characteristics, causative organisms, and treatment out-comes in patients presenting with endophthalmitis related to XEN stent implants.& BULL; DESIGN: Retrospective, noncomparative consecutive case series. & BULL; METHODS: Clinical and microbiologic review was per-formed 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 presenta-tion, organisms identified in ocular cultures, treatments received, and visual acuity at last follow-up.& BULL; RESULTS: The current study included 8 eyes from 8 pa-tients. All cases of endophthalmitis occurred > 30 days af-ter implantation of the XEN stent. At the time of presen-tation, there were external exposures of the XEN stent in 4 of 8 patients. Five of the 8 patients had positive intraoc-ular cultures, all of which were variants of staphylococcus and streptococcus species. Management included intrav-itreal 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.& BULL; CONCLUSIONS: Endophthalmitis in the setting of XEN stents results in poor visual outcomes. The most common causative organisms are staphylococcus or streptococ-cus 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. (Am J Ophthal-mol 2023;253: 37-43.& COPY; 2023 Elsevier Inc. All rights reserved.)