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W. J. Wirostko, D. J. Covert, D. P. Han, T. B. Connor, J. E. Kim; Spectrum of Microbiological Organisms Isolated From Explanted Scleral Buckles. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5770.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the results of bacterial culture testing on scleral buckles undergoing explantation for various reasons at an academic eye center.
A retrospective review of all scleral buckles removed between 1988 and 2006 at the Eye Institute, Medical College of Wisconsin was performed. Patient records were reviewed for indication of buckle removal, the clinical diagnosis of scleral buckle infection, presence of microbiological testing, and bacterial culture results.
Forty cases of scleral buckle removal were identified. Average patient age at the time of removal was 54.2 years. Indications for removal included exposure without clinical infection (43%), clinical infection without exposure (16%), exposure and clinical infection (13%), chronic irritation (13%), extrusion with displacement (11%), and glaucoma requiring shunt (3%). Bacterial cultures were obtained in 7(63%) of 11 cases with clinical infection, and isolated an organism in 4 (57%) of these 7 patients. Organisms identified included methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Mycobacterium abscessus, and coagulase negative Staphylococcus species. Bacterial cultures were obtained in 11 (38%) of 29 cases without clinical infection, and isolated an organism in 3 (27%) of these 11 patients. Organisms identified included Nocardia species, Alcaligenes xylosoxidans, and Mycobacterium chelonae.
Bacterial microorganisms can be isolated from explanted scleral buckles, both when they appear clinically infected as well as not clinically infected. Scleral buckles appearing clinically infected may be associated with more virulent organisms, and a greater chance of identifying an organism. However, cultures may still be negative in up to 43% of cases. Explanted scleral buckles appearing not infected may still produce positive bacterial cultures in up to 27% of cases, often with less virulent organisms isolated. Bacterial cultures may be of value for both clinically infected and non-infected scleral buckles upon removal.
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