Orbital cellulitis following silicone-sponge scleral buckles

Arie Y Nemet, Joseph R Ferencz, Ori Segal, Amit Meshi

Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel

Background: Acute or chronic infection of the scleral explant is rare. We report seven cases of scleral explant infections that caused orbital cellulitis.
Materials and methods: This was a retrospective chart review of oculoplastics at oculoplastics and vitreo-retinal units in a secondary referral hospital. All subjects had orbital cellulitis secondary to scleral buckle in the range of January 1990 to March 2010. Demographics, imaging studies, and pathology specimens were reviewed.
Results: A total of 841 silicone-sponge scleral buckle implants for rhegmatogenous retinal detachment were performed. Forty were extracted (4.75%; annual rate of 1.9 cases). Seven (0.83%) had orbital cellulitis. The mean time from implantation to presentation was 5.7 years. There was bacterial growth in all specimens, with Staphylococcus aureus in four.
Conclusions: Patients who are operated on with silicone-sponge scleral buckling for rhegmatogenous retinal detachment sometimes require removal of the implant because of infection. However, the infection rate is low. Patients should be followed in the long term for possible complications.

Keywords: scleral explant infection, scleral buckle, orbital cellulitis, rhegmatogenous retinal detachment