A 65-year-old Japanese man with a 25-year history of glaucoma secondary to idiopathic uveitis in his right eye and had been treated with several classes of glaucoma medications was referred to our hospital for further consultation. He had cataracts in both eyes, and did not have other ocular diseases, such as uveitis or glaucoma in his left eye. He had a history of renal cancer at the age of 52 years and had systemic hypertension. He reported a 36-year history of smoking (approximately 60 cigarettes per day). He had undergone three mitomycin C-augmented trabeculectomies and two bleb revision procedures, with a history of unspecified bleb-related infection 12 years prior in his right eye. The best-corrected visual acuity (BCVA) for his right eye was 20/100, with intraocular pressure (IOP) of 30 mmHg on five classes of glaucoma medications. His angle was 360° closed by peripheral anterior synechiae, and his kinetic visual field defects were Aulhorn-Greve grade V. Because of the extensive surgical scars in the superior hemisphere due to the multiple glaucoma surgeries and prior bleb-related infection, we decided to implant a Baerveldt glaucoma implant (BG101–350, Johnson & Johnson, Tokyo, Japan) in the inferonasal quadrant, in combination with clear corneal phacoemulsification, aspiration and intraocular lens implantation in February 2018. The silicone tube was ligated near the plate using 7–0 VICRYL® (Ethicon Inc., Somerville, NJ, USA), inserted into the anterior chamber (AC) and covered with a full-thickness donor scleral patch graft. Two venting slits were created using a 7–0 VICRYL® needle proximal to the ligation. His post-surgical IOP was decreased to low-teens with four classes of glaucoma medications. Ten months after the surgery, his right AC was clear, BCVA was 20/50, and IOP was 12 mmHg. However, the tube was exposed in the inferonasal quadrant, and dehiscence of the overlying conjunctiva and erosion of the scleral patch graft were evident. Since we didn’t find any signs of infection in the AC or surrounding area of the tube, we started topical gatifloxacin 0.3% (Senju Pharmaceutical, Osaka, Japan) immediately after diagnosis and waited for the arrival of ordered donor sclera. Eleven days after tube exposure, at the time of the preoperative examination, we found signs of endophthalmitis in his right eye, in which there were grade 3 cells in the AC and grade 1 cells in the anterior vitreous body. The root of the tube was surrounded by a plaque at the site of insertion in the AC. The patient was diagnosed with infectious endophthalmitis secondary to tube exposure in December 2018. Slit-lamp examination showed that the tube was clear of purulence posterior to the plaque and the bleb was clear and translucent; we determined that the infection had not spread to the bleb yet. Topical cefmenoxime 0.5% (Senju Pharmaceutical, Osaka, Japan) and gatifloxacin 0.3% administered every 2 h were not effective. Two days after diagnosis of endophthalmitis, the scleral patch graft was removed, and the exposed tube and surrounding area were sterilized using 10 mL of 0.025% polyvinyl alcohol-iodine (PA·IODO Ophthalmic and Eye washing Solution, Nitten Pharmaceutical, Nagoya, Japan) diluted with physiological saline. The silicone tube was withdrawn from the AC following confirmation of the absence of purulent exudation inside the tube. The specimens of the aqueous humor from the AC, which was the main inflammation site in this case, were obtained immediately after tube removal for culture testing. The removed tube and exposed area were vigorously irrigated with 20 mL of 0.025% polyvinyl alcohol-iodine solution. The site of the tube entry was sutured with 8–0 VICRYL® and no leakage from the AC was confirmed. Then, AC was irrigated with vancomycin 20 μg/mL (Shionogi, Osaka, Japan) and ceftazidime 40 μg/mL (GlaxoSmithKline, Tokyo, Japan). After that, the tube was tucked into the subconjunctival space. Medical therapy, including topical cefmenoxime 0.5% and gatifloxacin 0.3% administered every 2 h, was continued. Culture testing identified the growth of Corynebacterium species on the specimens of the aqueous humor of his right eye. Susceptibility test results indicated that Corynebacterium species were sensitive to penicillin, imipenem, minomycin, gentamicin, and erythromycin, with intermediate sensitivity to levofloxacin and cephem. We added ofloxacine ointment 0.3% (Santen Pharmaceutical, Osaka, Japan) application at bedtime. Even though the IOP ranged from 1 to 42 mmHg in his right eye after tube withdrawal, the length of time with the IOP over 30 mmHg was confined to five days with glaucoma medications. The infection completely resolved 1.5 months after tube removal. Thereafter, the tube was reinserted into the AC in the superior-nasal direction so that we could reduce the risk of further tube exposure and infection by avoiding contact between the tube and inferior eyelid. And then the tube was covered with a scleral patch graft and a free limbal conjunctival autograft harvested from his left eye in January 2019. Topical antibiotics were discontinued 1 month after the tube reinsertion. There has been no recurrence of infection or tube exposure since then, although a reduction in the size of the donor sclera was noted. His right BCVA was 20/50 and IOP was 12 mmHg on two classes of glaucoma medications in May 2021. Fundus photographs and kinetic visual field test results at the first and last visits demonstrated that the patient’s visual function had been maintained despite the ocular infection and following IOP fluctuation.