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Clinical and radiographic features of hydrolyzed MIRAgel scleral buckles: A comparative analysis
Edith R Reshef1, Larissa A Habib1, Rohini Rao2
1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America.
Abstract:
The MIRAgel (hydrogel) scleral buckle, introduced in the 1980s, was a novel material to repair retinal detachments. It was later discontinued due to the frequency of long-term complications related to buckle hydrolysis and expansion. These complications included pain, limited extraocular motility, and more serious complications such as infection or scleral perforation, which ultimately necessitated surgical extraction as late as 20-30 years after placement. Prompt and proper diagnosis and treatment is often delayed as these buckle-associated complications frequently mimic other orbital pathologies such as tumors or infections. The hydrolyzed MIRAgel buckle exhibits distinct radiographic features that are helpful in arriving at the correct diagnosis, particularly in cases of ambiguous clinical presentation or history. Here, we expand on the previously described radiographic features of hydrolyzed MIRAgel and compare them to features of common, mimicking orbital pathology.
Insights
The MIRAgel hydrogel scleral buckle caused long-term complications. Distinct radiographic features of hydrolyzed MIRAgel aid in diagnosing these issues, which mimic other orbital pathologies.
Area of Science:
- Ophthalmology
- Radiology
- Biomaterials Science
Background:
- The MIRAgel hydrogel scleral buckle was used for retinal detachment repair starting in the 1980s.
- It was discontinued due to frequent long-term complications like hydrolysis and expansion, leading to pain, motility issues, and severe outcomes such as infection or perforation.
Observation:
- Complications from MIRAgel buckles often mimic other orbital pathologies, delaying diagnosis and treatment.
- Hydrolyzed MIRAgel buckles present unique radiographic features.
Findings:
- This study details the radiographic characteristics of hydrolyzed MIRAgel buckles.
- These features are compared against common orbital pathologies that present similarly.
Implications:
- Accurate identification of MIRAgel buckle complications through characteristic radiographic findings is crucial.
- Understanding these features can improve diagnostic accuracy and patient management for delayed orbital complications.
