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Problems may arise after removal of hydrogel scleral explant
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Microstructural changes to hydrogel material may cause deterioration of scleral explants after 10 years or more, but explant removal may alleviate some ocular problems, according to a study.
However, removal may result in recurrence of retinal detachment and persistence of diplopia.
Medical records of 23 patients who had retinal detachment repair by episcleral buckle with hydrogel explants (MIRAgel, MIRA Inc.) were reviewed. The explants were later removed after signs and symptoms of scleral buckle extrusion.
There was a mean of 16.2 years between retinal detachment repair and removal of the extruded scleral buckle. Motility disturbance and the presence of a tumor-like palpable mass under the eyelid were the most common complaints. Extrusion occurred most often in the inferotemporal quadrant.
Explant removal eased pain, discomfort and the presence of the mass, the authors noted, but four of seven diplopia cases persisted and retinal detachment recurred in two patients. Removal of the scleral buckle did not affect visual acuity.
“Based on our observations, long-term, annual follow-up is recommended for any patient with a hydrogel scleral explant as surveillance for symptoms of extrusion,” the study authors said. “Prompt removal may prevent progression of some complications.”
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