Infection after retinal detachment surgery.

In 250 consecutive retinal detachment operations performed by the author, there were 14 cases (5.6%) of infection of the scleral buckle. The commonest infecting organism was Staphylococcus aureus. The surgery in these infected cases took longer than average, and utilized more than the usual amount of silicone sponge; a higher proportion were reoperations. After an average follow-up of 22 months, only six of the 14 had vision of 6/36 or better and of these, two had persisting inferior traction detachments. On the basis of this study and others, the preferred management of infected scleral buckles is to remove the sponge as soon as the diagnosis is made. The risk of redetachment is a lesser evil than the sequelae of prolonged inflammation which include traction retinal detachment, massive periretinal proliferation, and premacular fibrosis.