Post Xen stent infective scleritis- the not so Xen experience
Purpose
To describe a case of delayed-onset infective scleritis after Xen45 stent insertion.
Methods
Case Report
Results
A 68-year-old immunosuppressed female was referred with scleritis 19 months after left eye Xen45 gel stent insertion combined with mitomycin-C 0.04% and cataract surgery. She had 180 degrees of scleral necrosis and structural hypotony. Empirical antibiotics were initiated, and conjunctival swab grew mixed staphylococci. Despite clinical improvement the stent became exposed leading to worsening hypotony. Urgent surgery was performed to remove the stent and apply a tutoplast plug with overlying amniotic membrane. Her condition remained stable after 6 months with visual acuity of 6/12 and IOP 24 mmHg.
Conclusion
To our knowledge, this is the first reported case of scleritis following Xen45 insertion. It is a reminder that infection should always be considered in patients with surgically-induced necrotising scleritis and care should be taken with surgical choice in patients who are systemically immunosuppressed.
Conflict of interest
No
Authors 1
Last name
KINGSTON
Initials of first name(s)
EJ
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 2
Last name
McCluskey
Initials of first name(s)
P
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 3
Last name
Zagora
Initials of first name(s)
S
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 4
Last name
Raman
Initials of first name(s)
P
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 5
Last name
Symes
Initials of first name(s)
R
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 6
Last name
Lusthaus
Initials of first name(s)
JA
Department
Ophthalmology- Sydney Eye Hospital
City
Sydney
Country
Australia
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