Surgically induced necrotizing scleritis (SINS) is a rare inflammatory disease of the sclera that occurs following ocular surgery, specifically pterygium surgery and scleral buckling. Here, we report a case of SINS in a 78-year-old female patient after segmental scleral buckling for rhegmatogenous retinal detachment. The retina was restored after scleral buckling, and the postoperative course was uneventful. However, the patient developed ocular discharge and conjunctival hyperemia, indicating infection, after two months. The sclera became thinner and intraocular inflammation developed after buckle removal. Stenotrophomonas maltophilia was isolated from the ocular discharge, and the patient was treated with antibacterial agents susceptible to the bacteria. However, her symptoms persisted, and corrected visual acuity decreased from 20/25 to 20/1000. Oral steroid treatment was initiated because of the suspicion of SINS. Intraocular inflammation gradually subsided, the thin sclera was covered by conjunctival tissue, and the patient\'s corrected visual acuity improved to 20/32, which stabilized her condition. Infection with Stenotrophomonas maltophilia after scleral buckling is extremely rare, and SINS development in such cases is unprecedented.

OBJECTIVE: To present a case and surgical technique for management of Pseudomonas aeruginosa panophthalmitis secondary to an infected scleral buckle.
METHODS: Surgical technique video for management of an infected scleral buckle resulting in panophthalmitis with scleral buckle and suture explant and insertion of a subpalpebral lavage system.
RESULTS: After two months, the visual acuity was restored to hand motion, likely secondary to a fibrotic secondary membrane, and the retina remain attached. This reports the first description of globe salvage for panophthalmitis from a P. aeruginosa-infected scleral buckle.
CONCLUSIONS: This case encourages surgeons to remove all aspects of an exposed scleral buckle, including sutures, and emphasizes the importance of routine culture of all explanted material, even in the absence of clinical infection. In addition, this case encourages the use of a subpalpebral lavage in cases of severe P. aeruginosa ocular infections.

We report a case of restrictive strabismus caused by early scleral buckle (SB) migration within 1 month of surgery after successful medical management of SB infection. A 24 year-old man underwent scleral buckling surgery for left eye inferior retinal detachment (RD). A solid silicone buckle element was placed inferiorly along with an encircling silicone band. Two days after surgery, he presented with SB infection. Methicillin resistant Staphylococcus aureus was cultured from the exudate at conjunctival suture sites. Since the retina was well attached and it was only the second postoperative day, it was decided to retain the buckle. SB infection was treated with intravenous cefotaxime and topical fortified cefazolin and successfully eradicated. One month thereafter, anterior SB migration was noted on slit lamp biomicroscopy. Restrictive strabismus and diplopia were also noted. Eventually, SB removal was performed at 2 months. This case report highlights the role of infection and subsequent inflammation as a cause for buckle migration and restrictive strabismus in the early post-operative period. These changes can be seen as early as 1 month after primary surgery and may occur even after successful medical management of the SB infection.

We describe a rare case of scleral buckle (SB) infection with Serratia species. A 48-year-old male with a history of retinal detachment repair with scleral buckling presented with redness, pain, and purulent discharge in the left eye for 4 days. Conjunctival erosion with exposure of the SB and scleral thinning was noted. The SB was removed and sent for culture. Blood and chocolate agar grew Gram-negative rod-shaped bacillus identified as Serratia marcescens. On the basis of the susceptibility test results, the patient was treated with oral and topical antibiotics. After 6 weeks of the treatment, his infection resolved.

OBJECTIVE: To present a case of scleral buckle infection with Aspergillus flavus in a tertiary eye center in Saudi Arabia.
METHODS: A retrospective case report of a 28-year-old Saudi male who presented with a six-month history of conjunctival injection and discharge from the left eye which had undergone uncomplicated conventional retinal detachment surgery, at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, in the form of cryopexy, subretinal fluid drainage and scleral buckle (grooved segmental sponge and circumferential band with sleeve) for a macula on retinal detachment four years earlier. A diagnosis of infected extruded scleral buckle was made and the buckle was removed.
RESULTS: The infected scleral buckle was removed under local anesthesia with administration of sub-conjunctival irrigation of 50 mg solution of Vancomycin, and sub-conjunctival injection of 25mg of Vancomycin. Post operative microbiological studies revealed infection with silver staining of moderate Aspergillus flavus hyphae. Visual acuity of the left eye improved from 20/200 before surgery to 20/60 in the two years follow-up visit.
CONCLUSIONS: This case report indicates the importance of considering infection with multiple organisms - including fungal ones - in cases of scleral buckle infections in our population.