Delayed Mycobacterium abscessus scleral buckle infection 10 years after retinal detachment surgery: A case report and review of literature

Mycobacterium abscessus infection of a scleral buckle is an uncommon, potentially vision-threatening complication that may present years after retinal detachment surgery. We report a 68-year-old woman who developed chronic buckle infection with implant exposure and corneal ulcer 10 years after scleral buckling. Complete buckle explantation and microbiological evaluation, including Ziehl–Neelsen staining, mycobacterial culture, MALDI-TOF mass spectrometry, and molecular confirmation, identified M. abscessus. Susceptibility-guided systemic antimicrobial therapy resulted in resolution of infection and improvement in visual acuity from 4/60 to 6/12. This case highlights the importance of considering atypical mycobacteria in chronic buckle infections and prompt buckle removal with targeted antimicrobial therapy.