Retinal reattachment with a buckle, complications

  Aprox. 14 months ago my mother in law had cataract surgery. She was found to have a partially detached retina in one eye. During the surgery a gas bubble was put in and a "buckel" was sticthed into place. She has experienced dailey pain in that eye ever since. Yesterday we noticed that something was protruding from one side of the eyeball. After an examination we were told that the buckle has broken through the eye tissue that had been covering it up. The options presented are 1)To have it restiched to cover it back up. 2) Have the buckle removed. We are leaning towards having the buckle removed due to the dailey discomfort that she has had for the past 14 months. Can you tell us what the outlook is for her if the buckle is removed and also why this may ahve happened in the first place. Last, is it normal for the patient to have dailey discomfort from a buckel 14 months after it has been installed.
  Thank you in advance for any information that you may be able to provide.

[HFHS M.D.-NI]

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Retinal detachment is an uncommon occurrence after cataract surgery.  Depending upon the type of detachment, there are several ways to repair it including placement of a scleral buckle.  The buckle is normally covered with the tissue that surrounds the eye (conjunctiva).  In most people, a well placed and covered scleral buckle does not cause persistent discomfort.  In some cases, the buckle migrates forward and becomes uncovered.  This can cause irritation, pain and can predispose to infection.
It is important to have your mother-in-law examined by a retina specialist who will decide whether it is better to cover the buckle or remove it.  Removing the buckle may increase the risk of a recurrent retinal detachment.  If the buckle is not properly covered, there can be persistent pain and infection.
These options should be carefully discussed with her retinal specialist.
This information is provided for educational purposes only.  Please see your physician for diagnostic and treatment options.
Sincerely,
HFHS MD - NI