MIRAgel

Abstract

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.

Scleral buckle hemorrhagic cyst masquerading as an orbital tumor

“…The implant was discontinued due to complications, and it is currently recommended that MIRAgel buckling elements be promptly removed at the onset of discomfort to avoid late complications. 5 …”

Management of complex retinal detachment from intraocular invasion of MIRAgel-a case report

“…The episcleral hydrogel explant (MIRAgel, MIRA Inc., USA) was introduced in 1985 as an alternative to silicone explants for the treatment of rhegmatogenous retinal detachment (RRD). 1 , 2 It is no longer being chosen because of the associated late complications, which include but are not limited to extrusion, intrusion, eye motility disorder, cosmetic deformities, and periocular infections. 1 , 2 …”

The evaluation of ocular refractive error and axial length changes after scleral buckle removal

“…Scleral buckling (SB) is considered a significant surgical procedure for patients with rhegmatogenous retinal detachment (RRD) specifically for young phakic patients with anterior retinal breaks. [1234] Few uncommon complications were reported after SB surgery, such as buckle expose, infection, diplopia, buckle migration, and severe pain leaving buckle removal the sole choice for the surgeon. [25678] It should be noted that the main common concern for both the patients and surgeons is the risk of redetachment after buckle removal.…”