Late-onset progressive strabismus associated with a hydrogel scleral buckle.
A hydrophilic implant for scleral buckling was developed in 1980. Advantages include softness and elasticity, no dead spaces, ability to gradually absorb and release antibiotics, and stimulating production of a fibrous capsule around the implant. Short-term fellow studies in rabbits showed no clinical or histologic complications. Long-term complications of the hydrogel scleral buckle have emerged in the las 10 years. These included fragmentation, subconjunctival bulging, intraocular erosion, migration, and restriction of extraocular movement. We recently encountered a patient with progressive restrictive strabismus beginning 8 years after retinal detachment repair with a MIRAgel (hydrogel; MIRA, Uxbridge, MA) scleral buckle. Worsening complaints of diplopia and discomfort led to strabismus surgery. Untreatable retinal detachment resulted in enucleation.