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Infection after retinal detachment surgery
Abstract:
In 250 consecutive retinal detachment operations performed by the author, there were 14 cases (5.6%) of infection of the scleral buckle. The commonest infecting organism was Staphylococcus aureus. The surgery in these infected cases took longer than average, and utilized more than the usual amount of silicone sponge; a higher proportion were reoperations. After an average follow-up of 22 months, only six of the 14 had vision of 6/36 or better and of these, two had persisting inferior traction detachments. On the basis of this study and others, the preferred management of infected scleral buckles is to remove the sponge as soon as the diagnosis is made. The risk of redetachment is a lesser evil than the sequelae of prolonged inflammation which include traction retinal detachment, massive periretinal proliferation, and premacular fibrosis.
Insights
Infection of the scleral buckle occurred in 5.6% of retinal detachment surgeries. Early removal of infected buckles is recommended to prevent severe complications like massive periretinal proliferation.
Area of Science:
- Ophthalmology
- Surgical Infections
Background:
- Scleral buckle surgery is a common procedure for retinal detachment.
- Infection of the scleral buckle is a potential complication that can lead to poor visual outcomes.
Purpose of the Study:
- To determine the incidence of scleral buckle infection in retinal detachment surgery.
- To evaluate the outcomes of infected scleral buckles and establish optimal management strategies.
Main Methods:
- Retrospective analysis of 250 consecutive retinal detachment operations performed by a single surgeon.
- Identification and characterization of infected scleral buckle cases, including causative organisms and surgical details.
- Assessment of visual acuity and complications after an average follow-up of 22 months.
Main Results:
- 14 cases (5.6%) of scleral buckle infection were identified.
- Staphylococcus aureus was the most common infecting organism.
- Only six of the 14 infected cases achieved vision of 6/36 or better, with two experiencing persistent traction detachments.
Conclusions:
- Infected scleral buckles are associated with significant visual morbidity.
- Early removal of the infected sponge is the preferred management approach.
- The risks of redetachment are outweighed by the severe sequelae of prolonged inflammation.