Abstract Bioabsorbable materials enable temporary implantation without the need for subsequent implant removal. The aim of the present experimental study was to evaluate the suitability of a fibrous bioabsorbable implant made of poly-L/D-lactide (PLDLA) 96/4 fibres as an episcleral implant. The general tissue reactions were evaluated in subcutaneous tissues in rats in follow-up periods ranging from 3 days to 48 weeks. The episcleral tissue reactions were studied in rabbits with follow-up periods of one, three, five and 48 weeks. A silicone sponge implant was used as a control material and operations were performed using similar technique with both implants. Tissue reactions were located just around the implant area and consisted of an acute inflammatory reaction in the early follow-up periods, continuing as a foreign body inflammatory reaction. With episcleral implants there were no inflammatory cells seen within the sclera or in the retinal layers, and the structure of the retina and the cornea was also normal. The biocompatibility was good in the 48 week follow-up despite the relatively high surface area of the fibrous implant. The material had not degraded by 48 weeks. The indentation effect by the PLDLA implant (diameter of 3–3.5mm) was lower than that achieved with the silicone sponge implant (diameter 4mm). The depth of indentation decreased over time in both groups with comparable rates over the follow-up period of 5 months. The duration of the indentation effect was sufficient to be used for scleral buckling in retinal detachment surgery. In conclusion, the biocompatibility of a fibrous implant made of PLDLA 96/4 placed subcutaneously and episclerally was good in the follow-up lasting 48 weeks despite the relatively high surface area of the implant. The fibrous implant made of PLDLA 96/4 seemed to be well-tolerated by ocular tissues and the indentation effect was sufficiently long.

The purpose of this project is to study the risk of cataract development in patients who had undergone pars plana vitrectomy, scleral buckle, or both. A retrospective study was performed of phakic patients who underwent pars plana vitrectomy, scleral buckle, or both at Yale University Eye Center from 1998 to 2005. Mild postoperative cataract, defined as a change in severity of 1+, developed in 32 of 53 (60%) eyes following vitrectomy, 2 of 19 (11%) post scleral buckle, and 14 of 16 (88%) after both. Moderate postoperative cataract, defined as a change in severity of 2+, developed in 14 of 53 (26%) eyes post vitrectomy, 1 of 19 (5%) post scleral buckle, and 11 of 16 (69%) after both procedures. In eyes that underwent vitrectomy, a lens change of at least 2+ occurred in 8% at 3 months, 15% at 6 months, 21% at 12 months, and 26% at 36 months. In eyes status post scleral buckle surgery, one eye (5%) experienced a 2+ change at 36 months. In eyes that underwent both vitrectomy and scleral buckle, a lens change of at least 2+ occurred in 44% at 3 months, 50% at 6 months, 63% at 12 months, and 69% at 36 months. Cataract extraction surgery was performed in 15% of eyes post vitrectomy, 0% post scleral buckling, and 50% after both. The most common type of cataract to develop was nuclear sclerotic, which accounted for 61% of cataracts after vitrectomy, 50% after scleral buckling, and 50% after combined vitrectomy and scleral buckling. Scleral buckling surgery is associated with a low risk of cataract formation. Pars plana vitrectomy and combined vitrectomy and buckle have a higher risk of cataract development.