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The Removal of Hydrogel Explants: An Analysis of 467 Consecutive Cases
Niels Crama1, B Jeroen Klevering1
1Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands.
Purpose:
To describe the complications associated with hydrogel explants and to describe the indications, surgical technique, and risks involved in the removal of a hydrogel explant.
Design:
Single-center, retrospective interventional case series.
Participants:
Patients who underwent surgical removal of a symptomatic, swollen hydrogel explant.
Methods:
We reviewed the medical records of 457 consecutive patients (467 eyes in total) who underwent surgical removal of a symptomatic, swollen episcleral MIRAgel (MIRA Inc., Waltham, MA) explant at the Radboud University Medical Center from 1998 to 2011. We reviewed the initial symptoms, clinical findings, surgical aspects, and intraoperative and postoperative complications.
Main Outcome Measures:
Presenting symptoms, retinal redetachment rate, and intraoperative scleral perforation.
Results:
The median interval between initial placement of the hydrogel explant and removal of the explant was 159 months. More than 34% of the episcleral hydrogel explants developed symptomatic swelling and required surgical removal. Intraoperative scleral perforation or retinal redetachment related to the removal of the explant occurred in 11% of patients.
Conclusions:
The percentage of explants that ultimately develop symptomatic swelling is considerably higher than reported previously. A swollen hydrogel explant can be removed many years after the primary detachment surgery, and 11% of cases develop intraoperative scleral perforation or retinal redetachment.
