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[Four cases of late infection following scleral buckling procedure]
D Watanabe1, J Fujie, S Kawano
1Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.
Abstract:
We report four cases with late infection following a scleral buckling procedure. These cases were a 44-year-old male, a 52-year-old female, a 59-year-old male, and a 60-year-old male. All of these cases developed conjunctival injection, chemosis, and mucopurulent discharge 7 to 15 years after the procedure. The symptoms did not improve despite months of medical therapy, suggesting scleral buckle infection, and finally the buckling materials were removed. Solid silicone was used in 2 cases, and a sponge was used in 2 cases, with encircling elements in 1 case, and without encircling elements in 3 cases. Pus culture of the removal exoplant revealed fungaul infection in 2 cases. The others were negative, but bacterial infection was suspected from their clinical course and intraoperative findings. After removal of the buckles, the symptoms improved rapidly in all cases and there was no recurrence of retinal detachment. Scleral buckle infection should be suspected and removal of buckling materials should be considered, in cases with refractory conjunctival and scleral inflammation even years after scleral buckling procedure.
Insights
Late infection years after scleral buckling procedures can occur. Prompt removal of buckling materials is crucial for resolving inflammation and preventing retinal detachment recurrence.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Scleral buckling is a common surgical procedure for retinal detachment repair.
- Late complications following scleral buckling are infrequently reported.
Observation:
- Four patients presented with symptoms of conjunctival injection, chemosis, and mucopurulent discharge 7-15 years post-scleral buckling.
- Symptoms persisted despite prolonged medical management, indicating a potential infection of the buckling material.
Findings:
- Scleral buckle infection was diagnosed, and explantation was performed.
- Cultures from explanted materials revealed fungal infection in two cases; bacterial infection was suspected in the others.
- All patients experienced rapid symptom resolution and prevention of recurrent retinal detachment after buckle removal.
Implications:
- Scleral buckle infection should be considered in patients with refractory ocular inflammation years after surgery.
- Surgical removal of infected buckling materials offers a definitive treatment and prevents recurrence of retinal detachment.