Document Detail


Late complications of hydrogel scleral buckle implants and a technique for effective removal.
MedLine Citation:
PMID:  23034689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this article is to describe complications of hydrogel (MIRAgel) scleral buckle implants that may appear many years after implantation, and to describe an effective technique to facilitate safe removal of these implants, which become extremely friable with time.
METHODS: Four case reports of patients with complications of hydrogel orbital implants and a technique for removal of the implants are described with review of the literature. The technique involves a conjunctival incision into each involved quadrant, followed by use of blunt instrumentation for "push" and a Frasier suction handpiece for "pull" to allow segmental removal. This technique limits the tendency of the implant to fragment, which has been a problem described with previous techniques.
RESULTS: Cases typically present simulating an orbital tumor or infection, with the diagnosis not immediately apparent, as was the case in 3 of 4 cases in our series. The technique we used allowed for expeditious removal and prompt recovery in all 4 patients.
CONCLUSIONS: Hydrogel scleral buckle implants can produce late complications that may be difficult to diagnose and manage. The "push-pull" technique described in this article facilitates effective removal, and may have implications for other types of orbital hydrogel implants as well.
Authors:
Ayo-Lynn Richards; Dale R Meyer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ophthalmic plastic and reconstructive surgery     Volume:  28     ISSN:  1537-2677     ISO Abbreviation:  Ophthal Plast Reconstr Surg     Publication Date:    2012 Nov-Dec
Date Detail:
Created Date:  2012-11-09     Completed Date:  2013-03-08     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  8508431     Medline TA:  Ophthal Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  455-8     Citation Subset:  IM    
Affiliation:
General Ophthalmology, Lion's Eye Institute, Albany Medical Center, Albany, New York, USA. alynnricha@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Device Removal / methods*
Female
Humans
Male
Middle Aged
Ophthalmologic Surgical Procedures*
Polyhydroxyethyl Methacrylate / analogs & derivatives*
Postoperative Complications*
Retinal Detachment / surgery*
Scleral Buckling / adverse effects*,  instrumentation
Chemical
Reg. No./Substance:
116788-62-6/Miragel; 25249-16-5/Polyhydroxyethyl Methacrylate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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