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To better delineate predisposing factors, manifestations, and management, we reviewed reported cases of erosion/intrusion of “episcleral silicone buckling elements” in the literature (Table 1). Here we reported two cases of erosion/intrusion of episcleral silicone buckling elements. The incidence of erosion/intrusion of buckling elements has decreased substantially since episcleral silicone sponges and rubber elements became the most common materials for the SB. This complication was common when polyethylene tubes, Arruga sutures, and intrascleral silicone implant were used for scleral buckling which nowadays all can be considered obsolete. In early decades following introduction of SB surgery, erosion or intrusion of buckling elements into the eye were much more common. However, she reported good vision and no recurrence of symptoms. In following 16 months, despite multiple telephone recalls, patient did not comeback for followup visits. To stabilize the retina as much as possible in case that buckle removal was needed, additional barrier laser was done. Fluorescein angiography was performed to rule out other causes of vitreous haemorrhage (Fig.
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To further clarify the pathology an orbital computed tomography was done (Fig. Partial resolution of haemorrhage revealed an intruded sponge segment in inferior vitreous cavity (Fig. Drainage of subretinal fluid was done via a 3 mm long sclerotomy which subsequently was closed with a mattress suture and treated with cryopexy”.Ĭlose observation was scheduled. Tire and band were passed beneath the muscles and fixed to the sclera by Mersilene sutures. According to her surgical records, SB had been performed for an inferior rhegmatogenous retinal detachment (RRD): “after localizing, cryopexy was applied and a sponge segment was placed on the hole.
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The same eye had undergone cataract surgery and SB surgery, three and 29 years earlier, respectively. In the right eye, a vitreous haemorrhage blocking the fundus view was observed. Best corrected visual acuity (BCVA) was 20/200 in the right eye and 20/20 in the left eye. She reported similar episodes of transient visual obscuration in the same eye in recent 2 years with spontaneous resolution.
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Patients who have a history of SB need lifelong follow-up and this diagnosis should be considered if attributable signs and symptoms occurred.Ī 48-year-old woman presented with visual loss in her right eye. Unnecessarily destructive techniques may predispose the eye to this complication and should be avoided. ConclusionĪlthough the erosion/intrusion of a silicone episcleral buckle is rare, it may have serious consequences and optimal management can be challenging. The detachment was managed with pars plana deep vitrectomy, endolaser, an encircling silicone band, and silicone oil injection. Ten years ago, he had developed an aphakic RRD in the left eye. Twenty years earlier, he had undergone lensectomy for bilateral childhood cataract. Case 2: A 26-year-old man was referred for retinal evaluation. After Close observation, Partial resolution of haemorrhage revealed an intruded sponge segment in inferior vitreous cavity. Case presentationĬase 1: A 48-year-old woman with a history of scleral buckling for an inferior rhegmatogenous retinal detachment presented with visual loss in her right eye. The authors briefly review the literature on clinical presentation and management of the episcleral silicone buckling erosion and intrusion. Therefore, this diagnosis should be considered if attributable signs and symptoms including vitreous haemorrhage occurred after scleral buckling. Although the erosion/intrusion of a silicone scleral buckle (SB) is rare, it may have serious consequences and optimal management can be challenging. The authors report two cases of the scleral buckles intrusion and erosion that presented many years after primary surgery with vitreous haemorrhage in one of them.