Extraocular observations in episcleral sponge implants

The follow up of 262 cases of retinal detachment operated on after the Custodis Lincoff method in combination with cryopexy permitted the following observations: (1) The implant protruded in a number of cases under an intact conjunctiva and Tenon's capsule without discomfort to the patient. This protrusion depended mainly on the size and the manner of fixation of the implant, the distance of the point of fixation from the limbus and the condition of the conjunctiva. (2) Changes were observed in the conjunctiva in the fixation area, such as subconjunctival haemorrhage, cystoid degeneration of the conjunctiva and rupture with extrusion of the sponge. Subconjunctival haemorrhages were observed in 3.4% of the cases and were either absorbed or led to an inflammation. Cystoid degenerations occurred in 2.2% of our cases. These were limited to the edge of the sponge proximate to the limbus and involved only cases of radial fixation. Rupture of the conjunctiva and extrusion were noticed in 3.4% of the cases. (3) An inflammation due to the sponge was observed in 4.1% of the cases. Its time of onset varied between 3 days and 22 months. According to the time of onset the patients were divided into three groups. The gravity of the inflammation was proportionate to the earliness of the time of onset. Predisposing factors for the above complications are mentioned and discussed