Exposed but Uninfected Scleral Buckle

A scleral buckle is a piece of silicone rubber that is sutured to the sclera during a retinal detachment repair. Its purpose is to indent the wall of the eye and support the retinal break. Sometimes the conjunctiva that overlays the scleral buckle breaks down and the silicone rubber becomes exposed and even infected. In the case shown here, the exposed scleral buckle is denoted by red arrows. The patient had glaucoma tube surgery after the retinal detachment repair. A scleral patch associated with this procedure is denoted by blue arrows. It is possible that the manipulation of conjunctiva associated with this procedure was the inciting factor for the exposure. It is usually futile to attempt to resuture the conjunctiva over an exposed scleral buckle. Typically the conjunctiva will break down again. In most cases the scleral buckle is surgically removed. Then risk of retinal redetachment is approximately 17%.