Braunstein ea, Complications of Miragel: Pseudotumor, Arch Ophthalmol 2002;120:228-229   

In een artikel van febr. 2002 beschrijven Braunstein en Winnick een patiënt met een sterk – tot wel 4 maal zo groot (!) – gezwollen Miragel exoplant, die 13 jaar later onder het ooglid naar buiten trad.

Comment
Complications following retinal detachment surgery may necessitate the removal of the scleral buckling element. Some of these complications have been attributed to the type of bucklmg matenal used. Scleral buckling material has evolved from autologous fascia lata to nonabsorbable synthetic agents, such as polyethylene, silicone, and hydrogels.
Hydrogels are composed of a low-molecular-weight hydrophilic material that is water-permeable. ¹ Hydrogel scleral buckling elements (Miragel) were introduced in 1979 and marketed to have an advantage over the silicone agents currently being used.² The degree of buckle swelling could be varied by altering the state of hydration. The softness and elasticity of Miragel were thought to minimize erosion, and its lack of dead spaces promised to prevent infection by allowing the absorption and gradual release of antibiotics.³ Long-term complications related to the swelling properties of hydrogel exoplants have been reported. These problems have been attributed to erosion and migration, infection, granuloma formation, and fragmentation of the hydrogel material, resulting in particle retention on removal of the scleral buckling element.4
This case represents a complication that can occur as a result of the more than 4-fold volume expansion of the Miragel exoplant during a 13 year period. In this case, the profound increase in size of the exoplant caused restriction of extraocular movement and mimicked a periorbital mass lesion.