Hydrolyzed MIRAgel Scleral Buckle

A patient presented with one year of gradually worsening left eye pain and binocular diplopia. He had a history of remote retinal detachment repair in 1988 and prostate cancer in 2019 s/p radiation therapy in remission. In the left eye, he had limitations to gaze in all directions but worse in supraduction and adduction. Posterior exam in the left eye revealed attached retina with a scleral buckle temporally. The right eye had normal slit lamp and fundoscopic exam with full ductions. A CT scan of the orbits was done that revealed a cystic lesion in the superotemporal orbit near the lacrimal gland. B-scan ultrasonography of the left eye revealed a cyst that was posterior to the scleral buckle. Due to eye pain and restrictive strabismus, the patient was taken to the OR for a left orbitotomy and cyst removal. Intraoperatively, it was found that the cyst was a hydrated scleral buckle that was carefully removed in its entirety using blunt instruments. The patient was diagnosed with a hydrolyzed MIRAgel scleral buckle simulating an orbital lesion with ophthalmoplegia. Post operatively, the patient’s retina remained attached, and he had resolution of his pain. The strabismus service did not recommend strabismus surgery and the patient will be observed.

Presentation Date: 12/02/2021

Issue Date: 12/17/2021