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MA Afshari, NA Afshari, DJ D'Amico; A Study of Infected Scleral Buckles . Invest. Ophthalmol. Vis. Sci. 2002;43(13):652.
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Purpose: Infection is a severe complication of scleral buckling procedures for retinal detachment. Recognizing the type of the organism involved and its sensitivity are very important factors in the management of these patients. The purpose of this study is to evaluate the incidence and microbiology of infected buckles. Methods: We reviewed all of the scleral buckle procedures performed at the Massachusetts Eye and Ear Infirmary from 1994 to 1999, and identified the patients who developed infection within 30 days after surgery. Results: 3716 scleral buckling procedures were performed during this five-year period. Eleven patients (0.3%) developed acute postoperative infection. Among these patients, nine (82%) developed periocular infection while 2 (18%) developed panophthalmitis. The onset of symptoms was between postoperative day 4 to 22 with an average of 10. The most common organism was Staphylococcus aureus (73%). Other organisms included Staphylococcus warneri (18%) and mixed infection with Staphylococcus epidermidis and Staphylococcus aureus (9%). All of the identified microorganisms were sensitive to vancomycin, gentamicin, trimethoprim-sulfamethoxazole, tetracycline, Amoxicillin-potassium clavulanic acid, clindamycin, cefazoline, ciprofloxacin, and oxacillin. However, resistance was seen to ampicillin (72%), erythromycin (18%), and penicillin (82%). Conclusions: The infection rate in 3716 studied buckles is low (0.3%). Staphylococcus aureus is the most common organism. The isolates from infected buckles remain sensitive to several antibiotics, including vancomycin, gentamicin, and trimethoprim-sulfamethoxazole, which may be used in initial treatment.
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