Our Summary

This research paper talks about a rare case in which a hydrogel scleral buckle, a water-loving implant that expands over time, caused a problem in a patient’s eye. The implant eroded the top part of the eye socket and made a passageway into the frontal sinus, the area just above the eyebrows. This led to inflammation of the frontal sinus and adjacent brain tissue. The hydrogel material can be seen in medical images as a fluid-filled mass with a specific type of enhancement and hardening around the edges. The researchers highlight the importance of being aware that this hydrogel material can sometimes lead to severe eye problems, so it can be correctly identified and not mistaken for other eye diseases.

FAQs

  1. What is a hydrogel scleral buckle and how does it function?
  2. What are some potential complications of hydrogel scleral buckle surgery?
  3. How can hydrogel-induced erosion of the orbital roof into the frontal sinus be detected and diagnosed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scleral buckle surgery is to be aware of potential complications, including erosion of the orbital roof and formation of a sino-orbital communication. It is important to follow post-operative instructions carefully and to report any unusual symptoms or changes in vision to your doctor promptly. Regular follow-up appointments are also important to monitor for any potential issues.

Suitable For

Patients who are typically recommended scleral buckle surgery are those who have retinal detachment, particularly if it is caused by a tear or hole in the retina. Scleral buckle surgery is often recommended for patients with a high likelihood of retinal detachment recurrence or those who have not responded well to other treatments such as laser therapy or pneumatic retinopexy. Additionally, patients with certain types of retinal tears or detachments, such as those located in the lower part of the retina or those associated with high myopia, may also be good candidates for scleral buckle surgery.

Timeline

Before scleral buckle surgery:

  1. Patient undergoes a comprehensive eye examination to determine the extent of retinal detachment and the need for surgery.
  2. Patient may undergo pre-operative tests such as ultrasound imaging of the eye and optical coherence tomography.
  3. Patient may be instructed to avoid certain medications that can increase the risk of bleeding during surgery.

After scleral buckle surgery:

  1. Patient may experience pain, discomfort, and redness in the eye immediately after surgery.
  2. Patient will need to wear an eye patch or shield for protection and may be prescribed eye drops or ointments to prevent infection and promote healing.
  3. Follow-up appointments will be scheduled to monitor the healing process and check for any signs of complications such as infection or increased pressure in the eye.
  4. Patient may experience blurry vision, double vision, or other visual disturbances as the eye heals.
  5. In the long term, the scleral buckle may cause changes in the shape of the eye and may need to be adjusted or removed in some cases.

What to Ask Your Doctor

  1. What is scleral buckle surgery and why do I need it?
  2. What are the risks and potential complications associated with this surgery?
  3. How long is the recovery period and what can I expect during the healing process?
  4. Will I need to take any medications or follow any specific post-operative care instructions?
  5. How long will I need to follow up with you after the surgery?
  6. Are there any specific activities or behaviors I should avoid after the surgery?
  7. What should I do if I experience any unusual symptoms or complications after the surgery?
  8. How will the hydrogel material used in the surgery affect me in the long term?
  9. Are there any specific imaging tests or follow-up appointments needed to monitor for any potential complications from the hydrogel material?
  10. Are there any alternative treatment options to scleral buckle surgery that I should consider?

Reference

Authors: Tong JY, Smith M, Gout T, Tumuluri K, Taylor S. Journal: Ophthalmic Plast Reconstr Surg. 2022 Nov-Dec 01;38(6):e162-e165. doi: 10.1097/IOP.0000000000002216. Epub 2022 May 20. PMID: 35604377