Erosion and intrusion of silicone rubber scleral buckle. Presentation and management.
OBJECTIVE
To describe the clinical presentation and management of erosion and intrusion of silicone rubber implants that are used in scleral buckling procedures for the treatment of retinal detachment.


METHODS
The authors identified four patients from their practices during the last 20 years (1978-1998) who had erosion or intrusion of silicone rubber scleral buckles that were used to manage retinal detachment. Approximately 4400 scleral buckling procedures were performed during this period. A retrospective review of the medical records of all patients was performed. Factors that influenced management decisions concerning the intruding buckle are emphasized.


RESULTS
All four patients had myopia. The interval between placement of the scleral buckle and development of intrusion ranged from 1 to 20 years. The buckles were intrascleral in three cases and episcleral in one. Recurrent detachment and vitreous hemorrhage were indications for surgical intervention in three cases. After the surgical removal of buckling elements, visual acuity stabilized in all patients and the retina remained attached in all cases.


CONCLUSIONS
Erosion and intrusion of scleral buckle are rare complications of scleral buckling procedures. The intruding buckle may be left intact unless there is significant threat to the integrity of ocular structures, recurrent detachment, or hemorrhage. Manipulation of the encircling band or buckle does not necessarily alter the visual acuity or the status of the retina.
Nguyen
Q D
QD
Schepens Retina Foundation, Schepens Eye Research Institute, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
Lashkari
K
K
Hirose
T
T
Pruett
R C
RC
McMeel
J W
JW
Schepens
C L
CL
D000328:Adult; D001672:Biocompatible Materials; D020878:Device Removal; D005129:Eye Foreign Bodies / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000009:adverse effects*; D012826:Silicone Elastomers; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
D001672:Biocompatible Materials; D012826:Silicone Elastomers