Delayed-onset endophthalmitis associated with Ex-PRESS mini glaucoma shunt®.

The authors describe a 92-year-old man who developed delayed-onset endophthalmitis secondary to Bacillus sp. in his left eye 3 years after placement of an Ex-PRESS mini glaucoma shunt (Optonol Ltd., Neve Ilan, Israel). Seidel testing was positive over the Ex-PRESS mini glaucoma shunt. The patient underwent vitreous tap followed by intravitreal injections of vancomycin (1 mg/0.1 mL), ceftazadime (2.25 mg/0.1 mL), and dexamethasone (0.4 mg/0.1 mL), along with subconjunctival injection of vancomycin and tobramycin. The last recorded visual acuity was 3/200 in the left eye. With a 1-month follow-up, this case illustrates successful treatment with a vitreous tap and injection of intravitreal antibiotics. Vitrectomy and removal of the Ex-PRESS mini glaucoma shunt were not performed.