Indications and outcomes of scleral buckle removal in a tertiary eye care center in South India

Abstract

Purpose:To study the clinical profile of patients undergoing scleral buckle removal (SBR) surgery.Materials and Methods:All consecutive patients undergoing SBR surgery following scleral buckle for retinal detachment repair between January 2002 and December 2011 with a minimum postSBR follow-up of 6 months were included in this study. A record based on analysis of indications, methods, complications, and outcomes of the eyes was performed.Results:One hundred and two eyes of 101 patients (men = 77; 76.24% and women = 24; 23.76%) belonging to the age group of 15–78 years (mean 50 ± 15 years) were included in this study. Time gap between scleral buckle and SBR ranged from 2 to 216 months (mean 61 ± 51 months). Buckle exposure with clinical infection (81; 79.41%) was the most common indication. Of 90 (88.2%) eyes with positive culture, 75 (83.3%) revealed single and 15 (16.6%) revealed multiple microorganisms. Staphylococcus epidermidis (42; 41.2%), was the most common isolate. Fungus was isolated in 3 (2.94%) eyes. Globe perforation (14; 13.7%) and recurrent retinal detachment (7; 6.9%) were the commonest complications. Time gap between SBR and recurrent retinal detachment ranged from 15 days to 50 months (mean 12.2 ± 18.3 months).Conclusions:Most of the exposed scleral buckles developed clinical infection few months to years after surgery, ultimately requiring SBR. Recurrent retinal detachment after SBR may appear from few days to years later warranting a long-term follow-up.

A rare case of scleral buckle infection with Curvularia species

“…The most common indications for removal of a scleral buckle are buckle infection and buckle exposure [ 2 , 5 ], with their incidence ranging from 0.2–5.6% after a scleral buckling procedure [ 6 ].…”

“…The most commonly isolated organism has been reported to be coagulase negative staphylococcus, mainly Staphylococcus epidermidis [ 2 , 4 , 7 ]. However, there have also been reports of buckle infections caused my atypical mycobacteria, corynebacteria and fungi [ 8 ].…”

“…Being an external implant the scleral buckle is prone to get infected and the infection may set in even years after the primary procedure. The commonest organisms reportedly causing a scleral buckle infection are gram positive cocci [ 2 – 4 ], however, in rare cases a fungal infection may set in especially in an immunocompromised host. We report a case of buckle infection due to Curvularia species in an immunocompetent patient.…”

Microbiological profile and antibiotic susceptibility of scleral buckle infections in North India

“…[1] As the scleral buckle (SB) is an external implant, it is prone to get infected and the infection may set in even years after the primary procedure. The commonest organisms reportedly causing a SB infection are gram-positive cocci (GPC);[234] however, in rare cases, a fungal infection may set especially in an immunocompromised host. [56] A number of patients need removal of the SB during the course of their follow-up period,[789] though the number has significantly reduced due to changing techniques of surgery and higher standards of postoperative care.…”

“…We retrospectively analyzed patients who underwent SB removal and studied the microbiological profile and antibiotic susceptibility of these samples. Similar studies have been carried out in South India,[2417] and we aim to understand the differences in the SB infection trends in the northern part of the country as there are no studies in the current literature which analyze the same.…”