Microbial spectrum and emerging antibiotic sensitivity patterns in explanted scleral buckle elements-a 12 year retrospective analysis.

PURPOSE: To determine the indications for buckle removal, presenting features, microbiological spectrum and antibiotic sensitivity pattern 2. To determine the rate of retinal detachment following scleral buckle removal.

METHODS

A retrospective observational study was conducted in a high-volume tertiary eye care hospital in Southern India on all patients who underwent SB removal from the years 2009 to 2021 with a minimum follow-up period of 6 months after buckle removal.

RESULTS

Out of 1132 eyes that underwent Scleral buckling with or without combined or subsequent pars plana vitrectomy during the study period, 52 eyes underwent buckle removal. Thus, the rate of Scleral buckle removal was 4.59%. The most common indication for buckle removal was infection of the explant (71.15%). Microbial growth was demonstrated in 69.23% of eyes. The most commonly isolated pathogenic group of organisms was the Nocardia species (22.22%). Gram positive bacilli was the most common group of organisms detected in samples with bacterial and mixed fungal and bacterial isolates. The highest susceptibility was noted for Vancomycin followed by Cefotaxime, Gentamicin and Chloramphenicol. Amikacin appeared to have lesser efficacy than previously reported. The rate of recurrent detachment post buckle removal was 3.85%.

CONCLUSION

In contrast to previous studies, a preponderance of Nocardia species as the most commonly isolated pathogen was studied. A paradigm shift in antibiotic sensitivity pattern with an emerging resistance to Vancomycin and decreasing efficacy of Amikacin was demonstrated.