Purpose: To investigate scleral and episcleral histological alterations ind
uced by encircling explants used in scleral buckling procedures.
Methods: We performed a histopathological study of 20 enucleated eyes after
failure of retinal detachment surgery including encircling scleral buckle.
Results: Nonabsorbable materials were encapsulated and often gave rise to a
limited scleral invagination. The inner capsular surface was regular in 10
silicone explants, it was partially covered with hydrogel fragments and a
granulomatous foreign body giant cell reaction in 8 hydrogel explants. One
Arruga thread was encased in fibrosis and a catgut circle showed no encapsu
lation. Other changes were mostly related to the long-standing retinal deta
chment: peripheral anterior synechiae, anterior uveal effusion, persistent
retinal detachment, retinal gliosis, retinal atrophy retinal breaks, and si
licone oil droplets.
Conclusion: All nonabsorbable explants underwent encapsulation and prompted
scleral invagination. A granulomatous reaction accompanied hydrogel fragme
ntation. The long term fragmentation impact on implanted eyes remains unkno
wn.