Good Ideas Gone Bad: The MIRAgel Saga

The article by Crama and Klevering (see p. 32) makes important observations about significant long-term complications of hydrogel episcleral implants (MIRAgel; MIRA, Inc., Waltham, MA) used as scleral buckles in 467 eyes. This is the largest series reported of the complications of MIRAgel implants and illustrates how these implants swell slowly, eventually creating orbital masses, extraocular motility disorders, buckle exposure, and intraocular complications. The enlargement of the MIRAgel scleral buckle increased progressively, so patients did not experience problems until 5 to 10 years after their retinal detachment repair.