MIRAgel (MIRA, Waltham, MA) scleral buckle material was initially developed in the 1980s as an alternative to more traditional silicone buckles. Long-term follow-up has demonstrated complications necessitating removal due to unanticipated hydrolytic degeneration of the exoplant. Material expansion and fragmentation have led to pain, limited extraocular motility, ocular masses, infection, and eventual extrusion. Complications occur later than in other materials; most patients need removal an average of 7 years to 13 years after implantation. This case describes a previously not reported case of MIRAgel scleral buckle extrusion complicated by preseptal cellulitis and complete erosion of the material through the inferior eyelid and extrusion through the skin.
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