Erosion of implants in retinal detachment surgery

We analyzed erosion of intrascleral implants in 728 eyes that underwent scleral buckling procedures for retinal detachment surgery over the past 25 years. Types of implants included polyethylene tubes, solid silicone implants with and without silicone circling bands, and gelatin implants. The use of solid silicone implants and circling bands rather than polyethylene tubes has greatly reduced, but not eliminated, the problem of erosion. Erosion occurred in 62.3% of eyes with polyethylene tubes and in 3.8% of eyes with solid silicone implants with silicone circling bands. Factors associated with erosion included thin sclera, multiple operations, and glaucoma. Complications resulting from erosion were subretinal and vitreous hemorrhage, retinal detachment, and phthisis bulbi. Erosion is a problem that may appear up to 21 years after the scleral buckling procedure. The great number of retinal detachment repairs performed over the past 25 years make erosion of the intrascleral implant a concern of ophthalmologists today and a continued problem for the future.