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.

A Case of Rectus Muscle Transposition With Silicone Band in Strabismus Fixus With High Myopia

PURPOSE: To present a surgical result of rectus muscle transposition with silicone band without suture on the sclera in strabismus fixus with high myopia. CASE SUMMARY: A 73-year-old female patient with a 20-year history of bilateral esotropia and hypotropia visited our clinic. The patient`s right eye was aphakic because crystalline lens removal was performed 17 years earlier and the left eye was phthisical after retinal detachment, due to high myopia. Ocular movements in both eyes were severely restricted in all directions with the cornea barely visible. Ultrasound examination revealed posterior staphyloma of the retina. The axial length measurement was 32 mm in the right eye, and could not be measured in the left eye. Posterior tenon fixation of the medial rectus and inferior rectus muscle tendon was performed, in addition, fixation of the lateral half of the superior rectus and superior half of the lateral rectus muscle on the silicone band 10 mm posterior to each muscle's scleral insertion as a transposition procedure was performed. At 6 months postoperatively, there was no residual esotropia or hypotropia. The right eye maintained a gaze limitation but improved abduction and supraduction. CONCLUSIONS: In strabismus fixus with high myopia, posterior tenon fixation and muscle transposition with silicone band is an effective method without complication.

Surgery with Silicone Band for Sixth Nerve Paralysis

When esotropia and diplopia is developed by Sixth nerve paralysis treatments including operation are delayed for 6 months; botulinum toxin injection to the medical rectus which is antagonist muscle, lateral rectus resection, medial rectus recession, transposition of the vertical recti to the horizontal plane and Jensen procedure. But there is little possibility of recovery of full rotation in the direction of action of the attacted muscle with classic recess-resect surgery. Transposition of the vertical recti to the horizontal plane has the problem that original actions of the transposed muscles are weakened, and vertical deviation may be introduced. We attampted the surgery with silicone band for the 42 year-old patient who was not improved sixth nerve paralysis for ten months for the purpose of regainning muscle force and reposioning esotropia. Silicone band was passed the medial half of superior and inferior rectus muscles and sutured beneath the lateral rectus muscle. We had the disappearance of diplopia and esotropia and improvement of lateral rectus muscle force from -4 to -2. We could predict that this method was good for sixth nerve paralysis.

Fibrous Capsule Surrounding Silicone Encircling Band and Gore Tex(TM) Surgical Membrane: A Histological Study

As the anterior chamber tube shunt to an encircling band(ACTSEB) is a complicated procedure, extended polytetafluoroethylene(e-PTFE)-silicone tube implant is being attempated as a new glaucoma drainage implant in Korea. Anterior chamber tube shunt to a two-fold e-PTFE surgical membrane(ACTSSM) has better intraocular pressure(IOP) control than ACTSEB and kept the postoperative anterior chamber depth deep. ACTSEB and ACTSSM procedures were done in normal, colored rabbit eyes in order to compare the tissue response to each shunt. The rabbits were sacrificed 3 and 6 weeks later and the eyes were prepared for light microscopy. In general, foreign body responses were similar. Fibrous capsules lining the e-PTFE were thicker, less dense fibroblast, and less collagen than that lining the silicone encircling band. These findings seem to be related to the difference of the IOP lowering effect between ACTSEB and ACTSSM.