title: Long-term complications of hydrogel buckles.
abstract: OBJECTIVE
  To investigate long-term complications of hydrogel buckles used in scleral buckling surgery for retinal detachment.
  
  
  METHODS
  Clinical records of 31 patients who underwent scleral buckle removal between April 1998 and April 2001 were reviewed. Removed buckles were examined by scanning electron microscopy (SEM).
  
  
  RESULTS
  Nineteen patients were men and 12 were women, with a mean age of 43 years. Initial scleral buckling surgery using hydrogel buckles had been performed between February 1988 and October 1995. Patients presented at a mean of 8.5 years postoperatively with complaints of symptoms such as foreign body sensation and diplopia, prompting buckle removal. Buckles from 28 eyes, left in place for 5.8 years or more, were discolored, friable, and swollen. Buckles from three eyes, left in place for 5.5 years or less, appeared grossly unaltered. One eye with buckle swelling associated with a large retinal cyst underwent buckle removal and vitrectomy. SEM of deteriorated buckles showed distortion of micropores when compared to grossly unaltered buckles and unused controls.
  
  
  CONCLUSIONS
  Severe deterioration of hydrogel buckles may occur when they are left in place for 5 years or longer and may cause adverse symptoms and rarely intraocular complications. This deterioration is associated with changes in the microstructural architecture of the hydrogel material.
authors.affiliation: Kyorin Eye Center, Tokyo, Japan. oshitari@eye-center.org
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Oshitari
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hida
authors.forename: Annabelle A
authors.initials: AA
authors.lastname: Okada
authors.forename: Akito
authors.initials: A
authors.lastname: Hirakata
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008855:Microscopy, Electron, Scanning; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000150:complications / Q000601:surgery*; D012590:Sclera / Q000473:pathology / Q000648:ultrastructure; D012591:Scleral Buckling / Q000009:adverse effects*
chemical_list: D020136:Hydrogel, Polyethylene Glycol Dimethacrylate