Late Complications after Successful Scleral Buckling Surgery Using Hydrogel Buckles.

Lee, Sung Bok; Lee, Nam Ho; Lee, Yeon Hee; Jo, Young Joon

Original Article

Journal of the Korean Ophthalmological Society 2006;47(4):512-518.
Published online April 30, 2006.

Late Complications after Successful Scleral Buckling Surgery Using Hydrogel Buckles.

Sung Bok Lee, Nam Ho Lee, Yeon Hee Lee, Young Joon Jo

Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea. youngjoon@cnu.ac.kr

하이드로젤 공막돌륭물을 이용한 공막돌륭술의 후기 합병증

이성복,이남호,이연희,조영준

Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea

Correspondence: Sung Bok Lee, M.D.

Abstract

PURPOSE
To report late complications of hydrogel buckles (MIRAgel explant, MIRA, Waltham, U.S.A.) from use in scleral buckling surgery for retinal detachment. METHODS: The clinical records of 10 patients who underwent MIRAgel removal between January 1993 and March 2005 were reviewed. Preoperative computerized tomography (CT) scans were examined in three patients with suspected orbital mass. The unused and removed MIRAgel were examined by scanning electron microscopy (SEM). RESULTS: The average interval to MIRAgel removal was 9.4 years. Patients presented with complaints of restricted gaze (6 cases), exposed buckle (6 cases), palpebral mass (5 cases), and periorbital swelling (3 cases). Initially, 4 patients were misdiagnosed with orbital tumor or cellulitis. MIRAgel were removed by transconjunctival or skin incision, (totally in 7 eyes and partially in 3 eyes). CT scans showed circumferential soft tissue mass surrounding the globe with a peripherally-enhancing rim. SEM showed that unused samples had a smooth surface and uniformly sized micropores. The surfaces of the removed MIRAgel were uneven, with micropores that were distorted in shape and irregular in size. CONCLUSIONS: Because late complications with MIRAgel have various clinical aspects, complete history taking and ophthalmic examination are essential in making an accurate diagnosis and choosing proper treatment. Patients with MIRAgel should be followed up periodically, and its timely removal should be considered.

Key Words: Complication;Hydrogel;MIRAgel;Scleral buckling