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Purpose To report a case of post-operative endophthalmitis following combined cataract extraction and minimally invasive glaucoma surgery with placement of the iStent drainage device. Observation An 87-year-old woman with a nuclear sclerotic cataract and primary open angle glaucoma underwent elective phacoemulsification cataract extraction with iStent placement. Surgery was complicated only by the inability to properly place the second iStent despite several attempts. At 4 days post-operatively she was diagnosed with endophthalmitis. Despite the prompt intravitreal injections of broad spectrum antibiotics, she lost all perception of light. Cultures of anterior chamber aspirates failed to identify a causative organism. Conclusion and importance In what we believe to be the first report of endophthalmitis associated with placement of the iStent, complete loss of vision occurred. Surgeons need to be aware that iStent placement may be complicated by severe endophthalmitis.

Purpose To describe the safety and efficacy of the Ahmed ClearPath ® (ACP) 250 mm 2 glaucoma drainage device (GDD) in the treatment of refractory primary open-angle glaucoma (POAG). Patients and methods This was a retrospective, noncomparative, single-surgeon, interventional case series of adult patients with medically ± surgically refractory POAG undergoing ACP implantation. Intraocular pressure (IOP), the number of glaucoma medications, and complications were recorded over 24 months of follow-up. Primary outcomes included mean reductions in both IOP and medication use through 24 months, and secondary outcomes included the proportion of eyes achieving an IOP between 6 and 19 mmHg, IOP reduction by ≥20%, and reduction by ≥1 medication at last mean follow-up. Results Twelve eyes of 11 patients (mean age 71.3 ± 14.1 years) fit inclusion criteria and were enrolled. Most patients were Caucasian (n = 8), female (n = 10), and all had severe POAG (n = 11). The mean last follow-up was 18 months, at which time the mean (standard deviation) baseline IOP of 29.0 (7.6) mmHg was reduced to 12.2 (4.0) mmHg (58% reduction). 91.7% of eyes achieved an IOP between 6 and 19 mmHg, and 100% of eyes met an IOP reduction of ≥20%. Mean baseline number of glaucoma medications was 3.0 (0.9) and was reduced to 0.5 (0.7) at last mean follow-up (83.3% reduction), with 91.7% of eyes using ≥1 fewer medications. No long-term complications were observed, and short-term complications (mild hyphema, inflammation, and pain) were resolved by month 3. Conclusion To our knowledge, this is the second long-term study evaluating the efficacy of the Ahmed ClearPath drainage device in adult patients, and the first study with 24-months follow-up. The ACP device is safe and effective at reducing both IOP and medication burdens in patients with severe POAG. Additionally, minimal short-term complications were noted with no long-term adverse effects, increasing comfort for both the surgeon and the patient.

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Phacoemulsification systems with console-generated, low-frequency tones were audible to ophthalmologists with common types of sensorineural hearing loss.

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A 62-year-old woman presented with traumatic cataract induced by a misplanted minishunt penetrating into the peripheral iris and capsular bag.