Episcleral Miragel buckling elements removal. A clinical case-series]

Introduction: Due to a long-term alteration in their chemical composition, resulting in excessive swelling, Miragel(R) scleral buckles are now commonly removed. The aim of this study was to determine the characteristics and the outcome of patients needing Miragel(R) buckling removal. Methods: Retrospective analysis between 1997 and 1999 of the charts of patients successfully treated for retinal detachment and in whom a Miragel(R) episcleral buckle was removed after surgery with a minimal follow-up of 6 months after removal. Results: The study group consisted of 24 eyes of 13 women and 11 men. Their mean age at removal was 47.1 +/- 18.4 years. The removed buckle was encircling in nine cases (37.5%), circumferential (<180degrees) in 11 cases (45.8%) and radial in four cases (16.7%). An exposed buckle was observed in two cases (8.3%). Reasons for removal were excessive swelling of the buckle inducing ocular motility disturbance in 23 cases and infection of an extruded buckle in only one case. The mean time between implantation and removal was 91.9 +/- 28.7 months (range 20-120). One case of scleral perforation during removal and one case of retinal redetachment were observe Three cases of persistent ocular motility disturbance after removal were also noted. Conclusion: Late swelling of the buckle was the main reason for removal. Patients undergoing Miragel(R) buckling removal should be informed of scleral perforation during removal, retinal redetachment and persistence of ocular motility disturbance as possible complications.