J Korean Ophthalmol Soc.  2023 Nov;64(11):1048-1054. 10.3341/jkos.2023.64.11.1048.

Clinical Manifestations and Prognosis in Patients with Infectious Endophthalmitis after Ahmed Glaucoma Valve Implant Surgery

• Hong CM
• Kim GN
• Cho YW
• Kim SJ
• Chung I
• Yoo WS

• KMID: 2547868
• DOI: http://doi.org/10.3341/jkos.2023.64.11.1048

Abstract

Purpose
We studied the clinical features and assessed the treatment outcomes of infectious endophthalmitis subsequent to Ahmed glaucoma valve (AGV) implant surgery.
Methods
We performed a retrospective review of the medical records of patients who underwent AGV implant surgery between January 1, 2010 and May 31, 2022. Clinical course, microbiological lab results, and the treatment data of patients who developed infectious endophthalmitis were analyzed.
Results
Of 310 eyes that underwent AGV implant surgery, 9 (2.90%) developed endophthalmitis. The average time interval between AGV implant surgery and the diagnosis of endophthalmitis was 3.59 years. As initial treatment, all affected eyes received injections of intravitreal antibiotics, while four underwent primary pars plana vitrectomy. The implanted valve was removed in seven instances. Microorganisms were found in cultures from four cases. Two patients achieved a final best-corrected visual acuity (BCVA) above 20/200, while the other five had a final BCVA of hand motion or worse.
Conclusions
AGV implant-related endophthalmitis is uncommon and often results in poor visual outcomes, with unpredictable onset. Consequently, it is crucial to educate patients undergoing AGV implant surgery during regular follow-ups. Immediate evaluation and treatment are necessary for patients exhibiting symptoms after surgery.

Keyword

Endophthalmitis, Glaucoma drainage implant, Intravitreal injection, Vitrectomy