To analyze long-term complications of hydrogel (MIRAgel; MIRA Inc, Waltham, Mass) explants. Design: Institutional clinical study of a retrospective, interventional case series of patients. We included 415 patients with complete reattachment of the retina 6 months after surgery and up-to-date follow-up. Patients underwent ophthalmological examination at each visit (mean follow-up, 187 months), and 6 underwent computed tomography and/or magnetic resonance imaging. Main outcome measures included the MIRAgel explant removal rate, clinical manifestations related to removal, interval from the start of discomfort to removal, mean time from implantation to removal, culture yield of the removed elements, results of histological examination of the capsule surrounding the removed explants(12cases),andmicro-Fouriertransforminfraredspectroscopic analysis results of 3 recovered explants. Results: MIRAgel explant removal was necessary in 27 (6.5%) of 415 patients who received MIRAgel material and in 27 (7.6%) of 357 patients who had had it for 7 or more years. Clinical manifestations were related to swelling of the MIRAgel material, with a mean interval of 15 (range, 6-22) months from starting symptoms to removal. The infrared spectroscopic analysis demonstrated the presence of carboxylic groups in 3 recovered explants that had swollen considerably. Conclusion: Prompt removal of MIRAgel explants when discomfort starts should be considered to avoid increased incidence of complications.

Preoperative CRA parameters and LogMAR VAs (pre-, and postoperative 8 months) were influenced by preoperative RD duration in both no PVR and PVR. Preoperative CRA parameters were correlated with LogMAR VAs (pre-, postoperative 8 months, and the difference) only in PVR. Postoperative 8 months and preoperative LogMAR VAs were only correlated (with statistical significance) in macula-on cases of both the PVR and no PVR groups.

Endothelin 1 has shown a close relationship with IOP and CRA blood flow changes associated to retinal detachment as well as with proliferative vitreoretinopathy complications.

Purpose To find models that will explain the variability in postoperative visual acuity (VA) (logarithmic: logMAR) associated with unilateral primary rhegmatogenous retinal detachment (RD). Methods This was a prospective clinical cohort study of 33 patients with proliferative vitreoretinopathy (PVR: PVRoC3) and 33 without PVR, all of whom were candidates for scleral buckling (SB) surgery. Central retinal artery (CRA) Doppler sonography parameters (peak systolic, end diastolic velocities and resistibility index) and intraocular pressure (IOP) were measured before SB. Immunoreactive endothelin-1 (IR-ET-1) levels in both plasma and subretinal fluid (SRF) were measured using a radioimmunoassay. Visual outcomes were analysed by stepwise multivariate linear regression. The preoperative parameters used in the analysis included RD duration, IOP, logMAR VA, CRA parameters, preoperative plasma levels and intraoperative levels of IR-ET-1 in the SRF. ConclusionsThe duration of RD and the levels of IR-ET-1 in the SRF appear to be the best explanatory variables in the models for 8-month-postoperative logMAR VA variability in RD patients. RD surgery should be performed as soon as possible to best preserve VA.

Decreased OA blood flow velocities may explain lower IOP found in RD patients, and ET-1 levels may be responsible for both measurements.