Simultaneous Occurrence of Buckle Infection and Migration: A Case Report
<i>Background</i>: When scleral buckling is performed using a #240 encircling band anterior to the equator for rhegmatogenous retinal detachment, buckle migration may occur anteriorly, eroding the rectus muscle. There are few cases of buckle migration occurring simultaneously with buckle...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/3/449 |
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| author | Yasuyoshi Motose Hiroto Terasaki Misaki Ichiki Mahono Okawa Naohisa Mihara Narimasa Yoshinaga Taiji Sakamoto |
| author_facet | Yasuyoshi Motose Hiroto Terasaki Misaki Ichiki Mahono Okawa Naohisa Mihara Narimasa Yoshinaga Taiji Sakamoto |
| author_sort | Yasuyoshi Motose |
| collection | DOAJ |
| description | <i>Background</i>: When scleral buckling is performed using a #240 encircling band anterior to the equator for rhegmatogenous retinal detachment, buckle migration may occur anteriorly, eroding the rectus muscle. There are few cases of buckle migration occurring simultaneously with buckle infection. Notably, most previous reports included inadequate data on the pathophysiology of buckle migration and did not include the Hess test and perioperative images. <i>Case presentation</i>: A 36-year-old man with a history of atopic dermatitis underwent scleral buckling for rhegmatogenous retinal detachment of the left eye with #287 and #240 encircling bands at Kagoshima University Hospital. Four years later, he developed discharge, redness, and diplopia of the left eye. He was then referred to our hospital because buckle infection was suspected. The buckle was partially visible on the lower nasal side. Optical coherence tomography of the anterior chamber revealed the buckle to be on the nasal side and overlying the medial rectus muscle. Buckle migration and infection in the left eye was diagnosed, and early buckle removal was recommended. Two weeks later, on the day before surgery, conjunctival melting progressed in the nasal and inferior areas, and the buckle was exposed to a greater extent. In the surgical video at the initial surgery, the silicone band was confirmed to pass under the four rectus muscles, specifically the inferior and medial rectus muscles. At the beginning of the second surgery, we confirmed that the buckles were over the inferior and medial rectus muscles. As far as could be observed after buckle removal, the inferior and medial rectus muscles were not present at the normal location. Postoperatively, ocular pain and discharge quickly resolved. The subjective symptoms of diplopia also improved, and the postoperative Hess chart showed an improved ocular movement in the upward and lateral directions. <i>Conclusions</i>: Buckle migration is a rare postoperative complication of scleral buckling; however, patients at risk of buckle migration, such as those with encircling scleral buckle anterior to the eyeball, should be monitored with caution. If a buckle infection develops, buckle migration may occur within a short period, and early buckle removal should be considered. |
| first_indexed | 2024-03-11T06:12:03Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T06:12:03Z |
| publishDate | 2023-02-01 |
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| series | Medicina |
| spelling | doaj.art-1b7e5a2dddc8486a8f09890f59df47202023-11-17T12:30:47ZengMDPI AGMedicina1010-660X1648-91442023-02-0159344910.3390/medicina59030449Simultaneous Occurrence of Buckle Infection and Migration: A Case ReportYasuyoshi Motose0Hiroto Terasaki1Misaki Ichiki2Mahono Okawa3Naohisa Mihara4Narimasa Yoshinaga5Taiji Sakamoto6Department of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, JapanDepartment of Ophthalmology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, Japan<i>Background</i>: When scleral buckling is performed using a #240 encircling band anterior to the equator for rhegmatogenous retinal detachment, buckle migration may occur anteriorly, eroding the rectus muscle. There are few cases of buckle migration occurring simultaneously with buckle infection. Notably, most previous reports included inadequate data on the pathophysiology of buckle migration and did not include the Hess test and perioperative images. <i>Case presentation</i>: A 36-year-old man with a history of atopic dermatitis underwent scleral buckling for rhegmatogenous retinal detachment of the left eye with #287 and #240 encircling bands at Kagoshima University Hospital. Four years later, he developed discharge, redness, and diplopia of the left eye. He was then referred to our hospital because buckle infection was suspected. The buckle was partially visible on the lower nasal side. Optical coherence tomography of the anterior chamber revealed the buckle to be on the nasal side and overlying the medial rectus muscle. Buckle migration and infection in the left eye was diagnosed, and early buckle removal was recommended. Two weeks later, on the day before surgery, conjunctival melting progressed in the nasal and inferior areas, and the buckle was exposed to a greater extent. In the surgical video at the initial surgery, the silicone band was confirmed to pass under the four rectus muscles, specifically the inferior and medial rectus muscles. At the beginning of the second surgery, we confirmed that the buckles were over the inferior and medial rectus muscles. As far as could be observed after buckle removal, the inferior and medial rectus muscles were not present at the normal location. Postoperatively, ocular pain and discharge quickly resolved. The subjective symptoms of diplopia also improved, and the postoperative Hess chart showed an improved ocular movement in the upward and lateral directions. <i>Conclusions</i>: Buckle migration is a rare postoperative complication of scleral buckling; however, patients at risk of buckle migration, such as those with encircling scleral buckle anterior to the eyeball, should be monitored with caution. If a buckle infection develops, buckle migration may occur within a short period, and early buckle removal should be considered.https://www.mdpi.com/1648-9144/59/3/449buckle infectionbuckle migrationscleral buckling |
| spellingShingle | Yasuyoshi Motose Hiroto Terasaki Misaki Ichiki Mahono Okawa Naohisa Mihara Narimasa Yoshinaga Taiji Sakamoto Simultaneous Occurrence of Buckle Infection and Migration: A Case Report Medicina buckle infection buckle migration scleral buckling |
| title | Simultaneous Occurrence of Buckle Infection and Migration: A Case Report |
| title_full | Simultaneous Occurrence of Buckle Infection and Migration: A Case Report |
| title_fullStr | Simultaneous Occurrence of Buckle Infection and Migration: A Case Report |
| title_full_unstemmed | Simultaneous Occurrence of Buckle Infection and Migration: A Case Report |
| title_short | Simultaneous Occurrence of Buckle Infection and Migration: A Case Report |
| title_sort | simultaneous occurrence of buckle infection and migration a case report |
| topic | buckle infection buckle migration scleral buckling |
| url | https://www.mdpi.com/1648-9144/59/3/449 |
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