Hypotony caused by scleral buckle erosion in Marfan syndrome

PURPOSE: To describe hypotony caused by erosion of the conjunctiva and scle ra by a silicone scleral buckle. METHODS: Interventional case report. A 33-year-old man with Marfan syndrome presented with hypotony maculopathy and a collapsed globe 17 months after repair of retinal detachment with a silicone sponge and silicone encircling band. RESULTS: Examination in the operating room revealed extrusion of the buckle through the conjunctiva and full-thickness scleral erosion. The silicone b uckle was removed, and the scleral defect was closed with interrupted 8-0 n ylon sutures. Postoperative glaucoma was treated with cyclophotocoagulation . Eight months after scleral repair, visual acuity was RE: 20/40, intraocul ar pressure was 10 mm Hg, and the retina was attached. CONCLUSION: Full thickness scleral erosion secondary to a silicone exoplant causing hypotony is a rare long,term complication in patients with thin sc lera. (Am J Ophthalmol 2001;132:429-431. (C) 2001 by Elsevier Science Inc. All rights reserved.).