Propionibacterium Acnes Endophthalmitis in Ahmed Glaucoma Valve

Abstract

This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.

The Prevalence and Pathogenicity of Propionibacterium acnes Keratitis

“…There are several reports implicating P. acnes as the etiologic organism in conjunctivitis, orbital and preseptal cellulitis, 3 delayed-onset endophthalmitis after cataract extraction, 6 and glaucoma valve implantation. 7 There are only a few reports in the literature of culture-positive P. acnes keratitis. In a study of 30 cases of P. acnes keratitis, P. acnes was detected after an average of 15 days of incubation, which is more than twice the incubation time in our study.…”

“…In the eye, P. acnes has been associated with conjunctivitis, orbital and preseptal cellulitis, 3 infectious keratitis in a corneal graft, 4,5 and delayed-onset endophthalmitis after extracapsular cataract extraction with posterior chamber intraocular lens implantation 6 and after implantation of Ahmed glaucoma valve. 7 P. acnes has also been implicated as a pathogen in infectious keratitis. [8][9][10] The prevalence, pathogenicity, and virulence of P. acnes keratitis, however, have not been well documented.…”

Surgical interventions for primary congenital glaucoma

“…Pediatric models of most GDDs are available; the surgical technique is similar to that used in adults. Complications of GDD in children are similar to those in adults and include tube complications (corneal touch, implant exposure, tube block, dislocation), motility disturbances and infection (Al-Torbaq 2002;Gutierrez-Diaz 2001;Munoz 1991).…”

Delayed-Onset Streptococcus Pyogenes Endophthalmitis Following Ahmed Glaucoma Valve Implantation

“…Propionibacterium acnes was isolated in the first and Haemophilus influenzae in the other. 2,3 In our patient, the tube was not exposed, but one of the two polypropylene sutures securing the plate had penetrated the overlying conjunctiva and Tenon's capsule. We suggest that the conjunctival buttonhole caused by the suture provided the necessary entry site for Streptococcus pyogenes.…”