A Case of Silicone Band Migration Following an Encircling Procedure

PURPOSE: In the present study, a case of silicone band migration following an encircling procedure was reported. CASE SUMMARY: A seven-year-old male was admitted to our hospital after undergoing primary corneal suture and cataract extraction for traumatic corneal laceration and cataract in the left eye at another hospital. The cornea was well sutured, but due to vitreous bleeding and retinal detachment, we performed vitrectomy and silicone oil injection in combination with scleral buckling. The retina was well attached for 7 months following the procedure but the silicone oil was removed due to uncontrolled intraocular pressure elevation. Ten days later, the patient was readmitted for blurred vision in the left eye and vitreous bleeding as well as superotemporal retinal detachment were observed. During vitrectomy, we could not locate the indentation caused by scleral buckle, therefore extraocular area was closely examined. The scleral fixation sutures were well maintained in all 4 quadrants but the silicone band was not observed within the sutures. The band was located anterior to the fixation sutures and was displaced anterior to the medial rectus muscle insertion. The encircling silicone band was removed. The encircling procedure was again performed with a new silicone band combined with vitrectomy and silicone oil injection. Retinal attachment has been maintained and the silicone band well anchored since the operation. CONCLUSIONS: Anterior migration of the silicone band through the outer layer of the sclera or one or more tendons of recti muscles is a rare but potential complication of scleral buckling. Hence, clinicians must note the possibility of this complication when retinal detachment recurs and the encircling buckle is not observed.

Anterior migration of dexamethasone implant in a pseudophakic patient with intact posterior capsule.

Intravitreal application of Ozurdex® (Allergan, Inc., Irvine, CA, USA) which is a biodegradable, sustained‑release dexamethasone implant has been reported to be effective in the treatment of macular edema. Migration of such implant into the anterior chamber has been recently described in cases without perfect zonular or the posterior capsular integrity. Herein, we report the first case with anterior migration of Ozurdex® implant that mislocated just behind the intraocular lens (IOL) in an intact capsular bag. It is thought that such implant migrated anteriorly towards into the posterior chamber through weak zonules as the present case had a medical history of uneventful phacoemulsification surgery with the implantation of posterior chamber IOL. However, the migrated implant was well tolerated since there was no sign of the corneal complication, rise in intraocular pressure, and anterior chamber reaction. Close follow‑up was scheduled to find out any signs of anterior segment pathology. Meanwhile dexamethasone implant completely degraded at the 4th month of postoperative follow‑up.