MIGS devices and endophthalmitis

A US study has found that the prevalence of endophthalmitis following minimally invasive glaucoma surgery (MIGS) is similar to the reported incidences of endophthalmitis after other incisional glaucoma surgeries, but that implantable MIGS devices may increase that risk. 


Led by Dr Yoshihiro Yonekawa from Wills Eye Hospital at Thomas Jefferson University, the five-year study analysed 979 bacterial endophthalmitis cases. Of these, researchers found that 13 (1.3%) followed a MIGS procedure – nine with Glaukos’ iStent, three with Allergan’s Xen Gel stent and one with Alcon’s CyPass MicroStent.  


Reporting his findings at the American Society of Retina Specialists 39th Annual Scientific Meeting in October, Dr Yonekawa said that endophthalmitis was not associated with the 437 MIGS procedures that did not involve an implantable device, ie. goniotomy, trabeculectomy, gonioscopy-assisted transluminal trabeculotomy, trabectome, Kahook Dual Blade or Omni Surgical System. “Surgeons need to be cognizant of the potential risk of endophthalmitis with the use of implantable MIGS devices and the differences between endophthalmitis after MIGS procedures and endophthalmitis after standard cataract surgery. Not all MIGS devices are similar in their approach to lowering intraocular pressure, and thus each device and case of endophthalmitis may require unique management decisions.” 


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