Scleral erosion, phthisis bulbi, and orbital pseudocyst formation as a late complication of miragel scleral buckle surgery.

Abstract

The purpose of this study was to report a case of scleral erosion as a late complication of Miragel scleral buckle surgery. The resulting defect in the eye wall was associated with a phthisical eye and an inferior orbital pseudocystic lesion. Case report. An 81-year-old white woman presented with a Miragel scleral buckle 23 years after retinal detachment repair in the right eye. She complained of redness, swelling, and pain in the right eye, which was completely blind from glaucoma. There was evidence of implant extrusion in the inferior cul-de-sac. Orbital computed tomography scan revealed an inferior orbital cystic-appearing lesion. At the time of surgery, a fragmented Miragel implant was removed and 5 mL of clear fluid were drained from the pseudocyst. A 2.5-cm defect in the eye wall was partially repaired. Scleral erosion as a late complication of scleral buckle surgery is relatively well described with the buckle becoming visible in the subretinal space on funduscopic evaluation. Progression to a full-thickness scleral defect is uncommon. We present a unique case of postbuckle scleral necrosis associated with involution of the globe and development of a contiguous orbital pseudocyst.