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Erosion of implants in retinal detachment surgery
Annals of Ophthalmology
|May 1, 1983
Summary
Intrascleral implant erosion after retinal detachment surgery is a significant concern. While solid silicone implants reduced erosion compared to polyethylene tubes, it remains a risk, especially with thin sclera or multiple procedures.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Biomaterials
Background:
- Scleral buckling is a common surgical procedure for retinal detachment.
- Intrascleral implants are used to support the buckling procedure.
- Implant erosion is a known, albeit infrequent, complication.
Purpose of the Study:
- To analyze the incidence and risk factors of intrascleral implant erosion following scleral buckling.
- To compare erosion rates between different types of intrascleral implants.
- To identify complications associated with implant erosion.
Main Methods:
- Retrospective analysis of 728 eyes undergoing scleral buckling over 25 years.
- Categorization of implants: polyethylene tubes, solid silicone (with/without silicone circling bands), and gelatin.
- Evaluation of erosion incidence, associated factors, and resulting complications.
Main Results:
- Erosion occurred in 62.3% of eyes with polyethylene tubes vs. 3.8% with solid silicone implants and silicone circling bands.
- Factors associated with erosion included thin sclera, multiple surgeries, and glaucoma.
- Complications included hemorrhage, retinal detachment, and phthisis bulbi, with erosion appearing up to 21 years post-surgery.
Conclusions:
- Solid silicone implants with silicone circling bands significantly reduce erosion risk compared to polyethylene tubes.
- Intrascleral implant erosion remains a concern in retinal detachment repair, necessitating continued vigilance.
- Ophthalmologists must consider implant material, patient factors, and long-term follow-up to mitigate erosion risks.