Long term stability of circumferential silicone sponge scleral buckling implants.

Abstract

Abstract: : Purpose:The historical extrusion/ explantation rate of silicone sponge scleral buckles is 9–24.4%. This contrasts to the published explantation rate of solid silicone elements of 0.6–1.2%. Most previously reported studies involving silicone sponges were non–circumferential (quadrantic or multiple). This study was undertaken to assess the long–term stability of 360° circumferentially placed 3 x 5 mm silicone sponge elements. Methods:Interventional case series of 750 consecutive 3x5mm silicone sponge buckling implant surgeries. Retrospective review of operative reports and patient charts was performed. Results:504 patients had documented follow–up over 1 year. Median follow–up was 32.8 months. 6 patients underwent removal of the scleral buckling element (2 for diplopia, 1 acute post–operative infection, and 3 for extrusion). Median time to removal was 7.3 months. Extenuating circumstances contributed to 2/3 extrusions (one patient had longstanding absence of the medial rectus muscle and one patient had a suture granuloma requiring buckle removal). Of the entire series, less than 1% of patients required removal of the silicone sponge implant. Excluding patients with less than one year of documented follow–up, the long–term infection/extrusion rate was 0.8% and diplopia requiring removal was less than 0.4%. Conclusions:Circumferentially placed silicone scleral buckling sponges are very stable and are well tolerated. This long–term stability is comparable to previous published series of solid silicone elements used for retinal detachment surgery. This study implies that the material of the silicone sponge is as well tolerated as that of solid silicone elements when placed circumferentially.

Keywords: retinal detachment • clinical (human) or epidemiologic studies: outcomes/complications