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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 60  |  Issue : 1  |  Page : 126-127

Extrusion of a solid silicon band buckle migrating through the medial rectus muscle


Department of Retina and Vitreous, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India

Date of Submission01-Aug-2021
Date of Decision11-Sep-2021
Date of Acceptance10-Nov-2021
Date of Web Publication22-Mar-2022

Correspondence Address:
Dr. Jahnara Jaffar
Department of Retina and Vitreous Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli - 627 001, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_120_21

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  Abstract 


Exposure of the scleral explant is a rare complication of scleral buckling surgery. We report a case of a young male who presented to us with foreign-body sensation in his right eye for 1 month. He had undergone right eye scleral buckling surgery with an encircling silicon band 14 years back. On presentation, the right eye demonstrated an exposed segment of the silicon band medial to the limbus along with the torn off anchoring suture of inferonasal quadrant. The ocular movements were full and patient did not complain of diplopia. The band would have probably cheese-wired and migrated through the medial rectus muscle with slow reattachment of muscle to the sclera with scar formation.

Keywords: Exposed scleral buckle, exposed silicon band, extruded scleral buckle


How to cite this article:
Abdul Khadar SM, Jaffar J. Extrusion of a solid silicon band buckle migrating through the medial rectus muscle. TNOA J Ophthalmic Sci Res 2022;60:126-7

How to cite this URL:
Abdul Khadar SM, Jaffar J. Extrusion of a solid silicon band buckle migrating through the medial rectus muscle. TNOA J Ophthalmic Sci Res [serial online] 2022 [cited 2022 Jul 2];60:126-7. Available from: https://www.tnoajosr.com/text.asp?2022/60/1/126/340342



A 34-year-old gentle male presented to us with complaints of foreign body sensation in his right eye for past 1 month. The best-corrected visual acuity was 6/18 in the right eye and 6/6 in the left eye. He had undergone right eye scleral buckling with a 240 encircling silicon band combined with pars plana vitrectomy and silicon oil injection for rhegmatogenous retinal detachment 14 years ago and phacoemulsification with intraocular lens implantation and silicon oil removal 6 months later. Ocular examination at the current visit showed an exposed scleral buckle in the nasal quadrant 2 mm from the limbus along with the torn anchoring suture of the inferonasal quadrant [Figure 1]. The encircling band probably cheese-wired through the medial rectus muscle and cut through the conjunctiva to appear on the medial aspect close to limbus. On fundus examination, the retina was attached. There was no restriction of ocular movements. As the band slides anteriorly eroding the recti muscle slowly, the muscle tendon has enough time to re-attach to the sclera with scar formation.[1] Hence, there is no apparent disturbances in ocular motility. Our patient was advised buckle removal in view of his distressing ocular symptoms. The risk factors for anterior migration of the silicone band and subsequent extrusion are placement of the band anterior to the equator, excessive tightening of the band, or inadequate anchoring of the band to sclera.[2] We would like to stress the importance of regular periodic follow-up for patients who had undergone scleral buckling procedure.
Figure 1: Slit lamp image of the right eye showing an exposed silicon band in the medial aspect with the torn off anchoring suture of the inferonasal quadrant

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ashkenazi I, Moisseiev J, Bartov E, Treister G. Preserved action of a rectus muscle after transection by an encircling solid silicone band. Br J Ophthalmol 1991;75:508-9.  Back to cited text no. 1
    
2.
Maguire AM, Zarbin MA, Eliott D. Migration of solid silicone encircling element through four rectus muscles. Ophthalmic Surg 1993;24:604-7.  Back to cited text no. 2
    


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