Eyeworld

133 September 2015 EW MEETING REPORTER The Gold Shunt, a 24-karat gold micro-implant, will have 3-year follow-up data that will be released shortly. Extensive conjunctival scarring is not a contraindication for the device, she said. The CyPass has some promising short-term results, and the device can be used in conjunction with a cataract procedure. The iStent Supra has many similarities with the CyPass, Dr. Mosaed said. Both the CyPass and the iStent Supra are geared for early glaucoma with cataract extraction and IOL insertion, while the Gold Shunt can be used with late-stage refractory glaucoma, she said. Even though the risk profile with these devices is minimized compared with trabeculectomy, Dr. Mosaed still had a word of caution. "If you implant a device, there's always a lifetime risk," she said. "It is misleading to say there are no complications with these." Taking a closer look at endogenous endophthalmitis Endogenous endophthalmitis may only comprise 2.8% of endophthal- mitis cases—the exogenous form is much more common—but the effects can be devastating, said Tracy Kangas, MD, Ames, Iowa. Some factors that predispose patients to endogenous endophthalmitis in- clude diabetes, drug abuse, immuno- suppression, and invasive surgeries. Pain is a prevalent symptom of endogenous endophthalmitis, along with floaters, red eye, and hypopyon. With bacterial endogenous endophthalmitis, gram-positive bacteria are more common in the Western hemisphere of the globe, while gram-negative bacteria are more prevalent in the Eastern hemi- sphere. In children, Candida albicans is the most common bacteria seen. The loss of vision due to blindness with endogenous endophthalmitis occurs in 55% to 69% of patients, Dr. Kangas said. In fact, in patients with endogenous endophthalmitis and an extraocular foci infection, the mortality rate is 5% to 32%. Dr. Kangas said this form of en- dophthalmitis may be misdiagnosed continued on page 134 but that ophthalmologists should remain vigilant for it.

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