Scleral explant removal: the last decade

Purpose To examine the reasons for and outcomes of the scleral explant removal over the last decade. Methods A case note review of patients undergoing scleral explant removal in the operating theatre over a period of 10 years from January 1990 to December 1999. The following information was retrieved: age, sex, reason for explant removal, duration of explant (ie interval between primary surgery and explant removal), type of explant, symptomatic relief, preoperative and postoperative retinal status including redetachment, causes for redetachment, and follow-up. Mann - Whitney U-test and Fisher's exact test were used for statistical analysis. Results A total of 72 patients were eligible for the study. The average age was 54.1 +/- 17.0 years ( range, 17 - 84 years). The mean duration of explant was 50.1 years ( range, 1 - 282 months) and mean follow-up was 18.3 months ( range, 4 - 120 months). In all, 51 (70.8%) patients had a sponge silicone explant, 13 (18%) patients had a solid silicone explant, whereas eight (11.1%) patients had a combination of the two. The commonest reason for the explant removal was extrusion (n = 34, 47.2%) closely followed by pain ( n = 29, 40.2%). Symptomatic relief was achieved in 88% of patients. Six patients (8.3%) suffered retinal redetachment post explant removal. There was no statistically significant correlation between the reason for the removal or the duration of the explant and retinal redetachment. The majority (N = 5) of redetachment occurred within 6 months of the explant removal (P<0.01). Conclusion The Scleral explant removal provides symptomatic relief to the majority of patients, but is associated with a small risk of redetachment especially within 6 months postoperatively.