Korean J Ophthalmol.  2004 Jun;18(1):47-51. 10.3341/kjo.2004.18.1.47.

Diplopia and Periorbital Mass Associated with Miragel Buckling Explant

• Chung EJ
• Oh HS
• Lee SC
• Kwon OW

• KMID: 1115783
• DOI: http://doi.org/10.3341/kjo.2004.18.1.47

Abstract

A 28-year-old female presented with a palpable mass lesion on the superonasal aspect of her right globe and she had a progressive diplopia. She had a scleral encircling surgery with a Miragel explant (MIRA, Waltham, Mass, USA) for the tractional retinal detachment associated with pars planitis 9 years previously. On examination, she revealed restricted eye movements of her right eye. The magnetic resonance imaging documented a swelling of the Miragel explant that mimicked a periorbital mass lesion. The Miragel explant was removed and fragmentation of the explant was found intraoperatively. The removed Miragel explant was examined by a scanning electron microscopy, and this demonstrated a disintergrated and swollen structural composition of the Miragel explant. Postoperatively, her extraocular movement was almost restored and the retina remained well attached. Alterations in the structural composition of the Miragel explant results in an excessive swelling that causes a restriction of the extraocular movement, and this can mimick a periorbital mass lesion.

Keyword

diplopia, fragmentation; Miragel explant; pseoudotumor; scleral buckling

MeSH Terms

Adult
Diplopia/*etiology
Female
Granuloma, Plasma Cell, Orbital/*etiology
Humans
Magnetic Resonance Imaging
Polyhydroxyethyl Methacrylate/*adverse effects/*analogs & derivatives
Retinal Detachment/surgery
Scleral Buckling/*adverse effects
Visual Fields

Figure

• 

  Fig. 1A,B The magnetic resonance imaging documents the enlargement of the encircling Miragel explant. Sagittal view (A), Coronal view (B).

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  Fig. 2 A preoperative Hess screen test showing a severely restricted extaocular movement in her right eye (A). A postoperative Hess screen test showing the marked improvement in eye movements (B).

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  Fig. 3 The Miragel explant shows extreme friability and a tendency to disintegrate into fragments intraoperatively.

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  Fig. 4A,B The removed Miragel material demonstrated a structural deterioration with micropores, a distorted shape and an irregularity in size upon scanning electron microscopy (A: × 1000, B: × 5000).

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