Histopathology of Hydrolyzed MIRAgel Scleral Buckles

Abstract

Introduction: The goal of this study was to histopathologically evaluate the appearance of degrading MIRAgel scleral buckles so that they can be reliably distinguished by ophthalmic pathologists from other foreign materials. Methods: Retrospective chart review and histopathologic study with special stains, including Alcian blue, periodic acid-Schiff, Masson’s trichrome, and Perls’ Prussian blue for iron, of 4 cases between 2017 and 2019. Results: Hydrolyzed MIRAgel scleral buckles from 4 patients had a consistent histopathologic appearance. They had a honeycomb structure with the walls of the lattice ranging from distinct to poorly defined. The walls of the lattice were positive for Alcian blue, while the contents of each cell contained periodic acid-Schiff-positive material. Other special stains were not as valuable in highlighting the material. Discussion: Although the capsules of MIRAgel scleral buckles have been well studied, the material itself has not been. While clinical history and radiographic appearance are often diagnostic of a hydrolyzed MIRAgel scleral buckle, there are instances of preoperative ambiguity where histopathologic confirmation can be useful. Conclusions: MIRAgel scleral buckles have a distinct histopathologic appearance that can be readily distinguished from that of other foreign materials.