OUTCOME OF PARTIALLY EXPOSED SILICONE SCLERAL EXPLANT AMONG CASES PRESENTING WITH HEMOLACRIA

*Dr. Padma Prabhu

ABSTRACT

An attempt is made to describe the features of partially exposed silicone rubber scleral buckle among cases presenting with bloody tears. The cohort includes five adults who underwent standard scleral explant surgery for rhegmatogenous retinal detachment. Hemolacria followed recurrent attacks of periocular pain and chronic headache lasting for months. Persistence of symptoms despite topical and systemic anti-inflammatory agents including steroids was observed in all cases. Hypertension was an associated condition in four cases. Scleral thinning (necrosis in one case) was noted in all at the site of exposed buckle. Staphylococcus was isolated in four out of five cases, though only one had active infection. High index of suspicion is required regarding impending buckle extrusion in patients who have undergone scleral buckling presenting with recurrent scleral inflammation. The need for microbiological evaluation of the removed buckle in view of the subclinical buckle infections is stressed. Removal of the buckle is curative.

Keywords: Scleral buckle, extrusion, retinal detachment, staphylococcus, MRSA, infective scleritis. Hemolacria.