An intractable case of Pseudomonas aeruginosa infection after scleral buckling for rhegmatogenous retinal detachment

BACKGROUND: Scleral buckling is still a common procedure to repair rhematogenous retinal detachment, and acute or chronic infection of the scleral explant is rare. We report an intractable case of acute scleral explant infection by Pseudomonas aeruginosa. CASE: A 36-year-old man suffered from acute scleral explant infection by P. aeruginosa forty-eight hours after scleral buckling for rhegmatogenous retinal detachment. The infection was treated by intravenous administration of various appropriate antibiotics for eighteen days and washing the scleral explant with appropriate antibiotics, and appeared to be resolved. However, three months after the initial surgery, we had to remove the scleral explant because of recurrent infection. OBSERVATIONS: We encountered an intractable case of acute scleral explant infection by P. aeruginosa, that recurred and forced the removal of the scleral explant. CONCLUSIONS: We found that recurrence of infection necessitated removal of the scleral explant, even though the organism was sensitive to the antibiotics used to treat the infection, and there was an appropriate duration of treatment. Early diagnosis and countermeasures, first considering conservative management, which may have a role in delaying buckle removal, and thus reduce the risk of retinal redetachment, and help prolong the time until surgical treatment such as removing the scleral explant is required.