Pathologic processes associated with the use of scleral buckling in humans

Scleral buckling or indentation over a retinal tear or detachment was popularized by Ernst Custodis in 1953. Since then it has become one of the most popular and effective retinal reattachment surgical procedures. Although a few biologic materials such as fascia lata, lyophilized sclera and gelatin are used sometimes as scleral buckles, the most common material for buckles currently used is derivatives of medical grade silicone rubber or MAI. When the scleral buckling material is of foreign origin, the body reacts with acute and chronic inflammation, extrusion, and intrusion. The author has studied five eneucleated globes, with scleral buckles in place for periods of 3 to 48 months. The globes were removed for "painful blind eyes". The author's studies consisted of histomorphological analyses. The author observed foreign body granulomatous reaction and extensive fibrosis of Tenon's capsule and the sclera. The precise mechanism by which scleral buckling works remain uncertain at this time.