Bleb Associated Xen Gel Stent Endophthalmitis: A Case Report and Review of Literature

Purpose: To report a case of a unique late complication of the Xen gel stent, stent-related endophthalmitis was preceded by flattening of the bleb. Case Report: A 63-year-old female was presented with late-onset endophthalmitis preceded by flattening of the bleb two years post-insertion of Xen gel stent. B-scan of the posterior chamber revealed vitritis and hyaloid condensation, with no viral, fungal, or bacterial pathologies identified on anterior chamber tap. The patient's eye responded to injections of intravitreal antibiotics. Conclusion: Endophthalmitis can occur as late as 2 years after implantation of glaucoma drainage device implants (GDIs) like the Xen gel stent if bleb flattening or leaking leads to contact of the stent with the conjunctiva. Therefore, in case of blebs getting flat, ophthalmologists should watch them more often. Intravitreal antibiotics may also be effective rather than surgical removal in the case of a non-eroded stent complicated by endophthalmitis.

Automated summary

This case report highlights a unique late complication of the Xen gel stent, namely stent-related endophthalmitis, which was preceded by flattening of the bleb. The use of B-scan and anterior chamber tap helped in the diagnosis, and intravitreal antibiotics proved effective in treating the patient.