Intractable granuloma as a complication of polyethylene tube buckling procedures.

Abstract

This is a report of four cases of intractable granuloma which followed polyethylene tube buckling procedures for the treatment of retinal detachment. Since the first use of the buckling procedure at New York University-Bellevue Medical Center three years ago polyethylene tubes have been placed in 94 eyes. Thirty-three were partial tube implants and 61 were encircling tubes. The four granulomas occurred in eyes in which encircling tubes had been placed. The clinical course in the four cases was similar. Postoperatively the eye failed to whiten by the third or fourth week. The bulbar conjunctiva continued edematous and injected. The injection was extensive but seemed especially severe in one quadrant. The inflammation responded incompletely to antibiotics and steroids. As early as the sixth week a flat pink tongue of granuloma could be seen emanating from the wound closure in the area of maximum redness. The presence of a granuloma in what