Multimodality imaging of hydrogel scleral buckles

Hydrogel scleral buckles were used for treating retinal detachment in the 1980s and early 1990 s. However, these devices have a propensity to degrade over time and cause several long-term complications, including hydration and overexpansion, fragmentation, extrusion, intrusion, and intraocular erosion, and the potential to mimic mass lesions.

The imaging features of hydrogel scleral buckles and their complications are reviewed in this article.

Radiographic imaging plays an important role in managing patients with complications of hydrogel buckles. Hydrated buckles display attenuation intermediate between fluid and soft tissue on computed tomography, demonstrate approximately fluid signal on magnetic resonance imaging, and are anechoic on ultrasonography. Linear margins and peripheral dystrophic calcification are characteristic.

The constellation of imaging features helps distinguish expanded hydrogel buckles from other orbital diseases. Imaging also serves to precisely localize hydrogel scleral buckle components requiring removal.