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TitlePost Xen stent infective scleritis- the not so Xen experience
PurposeTo describe a case of delayed-onset infective scleritis after Xen45 stent insertion.
MethodsCase Report
ResultsA 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.
ConclusionTo 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 interestNo
Authors 1
Last nameKINGSTON
Initials of first name(s)EJ
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia
Authors 2
Last nameMcCluskey
Initials of first name(s)P
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia
Authors 3
Last nameZagora
Initials of first name(s)S
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia
Authors 4
Last nameRaman
Initials of first name(s)P
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia
Authors 5
Last nameSymes
Initials of first name(s)R
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia
Authors 6
Last nameLusthaus
Initials of first name(s)JA
DepartmentOphthalmology- Sydney Eye Hospital
CitySydney
CountryAustralia