gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Scleral perforation and postoperative hypotony as a possible complication of extraocular buckling surgery

Meeting Abstract

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  • Jörg C. Schmidt - Marburg/Germany
  • S. Mennel - Marburg/Germany

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V043

The electronic version of this article is the complete one and can be found online at:

Published: June 18, 2008

© 2008 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Scleral perforation is a possible complication of extraocular buckling surgery. Early diagnostic and treatment is essential to avoid further side effects.

Material and methods: A 43-year-old male complained decrease of visual acuity at the right eye. A half year before a retinal detachment OD was treated by buckling surgery. Following consecutive reattachment of the retina and increase of visual acuity, one month after surgery the patient again complained a deterioration of visual acuity and by this time a hypotony was diagnosed. The treatment by this time was an application of intravitreal triamcinolone and fill up of the anterior chamber with viscoelastics.

Results: At the first consultation in our department visual acuity was 0,3 and the intraocular pressure 4 mmHg. The anterior chamber was deep, the retina attached and at the central border of the buckle a depigmentation became evident. As a scleral perforation was suspected, a pars plana Vitrectomy with phacoemulsification and IOL implantation was performed. By removal of the buckle a scleral opening of 1mm and adjacent necrotic could be demonstrated. The nectrotic scleral tissue did not enable suturing. A scleral patch was necessary to tamponade the scleral opening and intraocular silicone oil was inserted. The postoperative ocular pressure was normal.

Conclusion: Postoperative hyopotony following extraocular buckling surgery could be a sign of intraoperative scleral perforation. This serious complication requires adequate diagnostic and treatment to avoid complications as endophthalmitis, retinal incarceration, cystoid maculopathy or phthisis bulbi.