Scleral and episcleral histological changes related to encircling explants in 20 eyes

Abstract

Purpose: To investigate scleral and episcleral histological alterations induced by encircling explants used in scleral buckling procedures.

Methods: We performed a histopathological study of 20 enucleated eyes after failure of retinal detachment surgery including encircling scleral buckle.

Results: Nonabsorbable materials were encapsulated and often gave rise to a limited scleral invagination. The inner capsular surface was regular in 10 silicone explants, it was partially covered with hydrogel fragments and a granulomatous foreign body giant cell reaction in 8 hydrogel explants. One Arruga thread was encased in fibrosis and a catgut circle showed no encapsulation. Other changes were mostly related to the long-standing retinal detachment: peripheral anterior synechiae, anterior uveal effusion, persistent retinal detachment, retinal gliosis, retinal atrophy, retinal breaks, and silicone oil droplets.

Conclusion: All nonabsorbable explants underwent encapsulation and prompted scleral invagination. A granulomatous reaction accompanied hydrogel fragmentation. The long term fragmentation impact on implanted eyes remains unknown.