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Scleral buckle removal following retinal reattachment surgery: clinical and microbiologic aspects
W E Smiddy1, D Miller, H W Flynn
1Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Fla.
Abstract:
Scleral buckle infection following retinal reattachment surgery is infrequent but not rare. We identified 45 cases among approximately 3000 scleral buckling procedures performed at our institution between July 1, 1985 and July 1, 1991. The scleral buckle was exposed in all 45, and the subsequent microbiologic culture was positive in 33. The most common causative organism was coagulase negative staphylococci (17 of 33 cases with positive cultures). Risk factors for an adverse outcome included positive culture, preoperative vision < or = 20/200, and preoperative retinal detachment. Broad spectrum antibiotics covered organism sensitivity profiles in 16 of the 18 cases tested. Prompt removal of infected buckles and treatment with broad-spectrum topical antibiotics are important for maintaining vision.
Insights
Scleral buckle infection, though infrequent after retinal reattachment surgery, requires prompt intervention. Early removal of infected buckles and broad-spectrum antibiotics are crucial for preserving vision in these cases.
Area of Science:
- Ophthalmology
- Surgical Infections
- Retinal Surgery
Background:
- Scleral buckle infection is an uncommon complication following retinal reattachment surgery.
- This study reviewed cases of scleral buckle infection to identify risk factors and outcomes.
Purpose of the Study:
- To analyze the incidence and characteristics of scleral buckle infections.
- To identify risk factors associated with adverse outcomes in these infections.
- To evaluate the effectiveness of treatment strategies for scleral buckle infections.
Main Methods:
- Retrospective review of approximately 3000 scleral buckling procedures.
- Analysis of 45 identified cases of scleral buckle infection.
- Microbiologic cultures were performed on exposed buckles.
Main Results:
- 45 cases of scleral buckle infection were identified over a 6-year period.
- Coagulase-negative staphylococci were the most common pathogens.
- Positive cultures, poor preoperative vision, and preoperative retinal detachment were risk factors for adverse outcomes.
Conclusions:
- Prompt removal of infected scleral buckles is essential.
- Broad-spectrum topical antibiotic treatment is vital for vision preservation.
- Understanding risk factors can guide preventative strategies.