Encapsulation of scleral buckling materials. A study of sixty specimens.

OBJECTIVE The purpose of the study was to obtain information on the encapsulation of two nonabsorbable biomaterials (silicone and hydrogel) used as explants in scleral buckling in retinal detachment surgery. DESIGN The study design was a histopathologic study on a cohort of capsule fractions and complete eyes. PARTICIPANTS Fifty-nine patients participated in this study, in which 60 specimens, including 37 hydrogel and 21 silicone capsule specimens as well as 2 whole eyes, were gathered. There were no control subjects. INTERVENTION The capsule specimens were obtained from eyes operated on previously for scleral buckling for retinal detachment. The two whole eyes were enucleated. All specimens were studied with routine optic microscopy. MAIN OUTCOME MEASURES Patient characteristics, type of scleral buckling, and number of operations performed were analyzed. Histologically, the capsular structure, its interface with the explant, and its different components also were studied. Remnants of the buckling material also were investigated. RESULTS There were 45 male and 14 female patients, with a mean age of 49 years. Histologically, capsule specimens had a fibrous matrix with fibroblasts and few inflammatory cells. Eighteen (48.6%) of 37 hydrogel capsule specimens displayed hydrogel fragments surrounded by a foreign body giant cell granuloma in 16 cases. CONCLUSION Nonabsorbable materials undergo encapsulation after implantation on the eye surface. Giant cell granuloma was observed in some hydrogel capsule specimens in relation to hydrogel fragmentation. The exact origin of this fragmentation remains unknown.

[1]  A DELLAPORTA,et al.  Experimental studies on a scleral buckling operation. , 1956, American journal of ophthalmology.

[2]  J. Korobelnik,et al.  MIRAGEL VERSUS SILASTIC USED AS EPISCLERAL IMPLANTS IN RABBITS; An Experimental and Histopathologic Comparative Study , 1995, Retina.

[3]  G. Gray,et al.  FIBROUS CAPSULE FORMATION AFTER SUBCUTANEOUS IMPLANTATION OF SYNTHETIC MATERIALS IN EXPERIMENTAL ANIMALS , 1974 .

[4]  David J. Wilson,et al.  Histopathologic study of the effect of retinal detachment surgery on 49 eyes obtained post mortem. , 1987, American journal of ophthalmology.

[5]  F I Tolentino,et al.  The MAI hydrophilic implant for scleral buckling: a review. , 1984, Ophthalmic surgery.

[6]  M. Refojo,et al.  HYDROPHILIC ACRYLATE SCLERAL BUCKLING IMPLANTS IN RABBITS: Long-term Clinicopathologic Observations , 1983 .

[7]  M. Refojo,et al.  Poly(methyl acrylate-co-hydroxyethyl acrylate) hydrogel implant material of strength and softness. , 1981, Journal of biomedical materials research.

[8]  F I Tolentino,et al.  Long-term complications of the MAI hydrogel intrascleral buckling implant. , 1992, Archives of ophthalmology.

[9]  W. Johnson,et al.  Concepts of Granulomatous Inflammation , 1984, International journal of dermatology.

[10]  J D Andrade,et al.  The foreign body reaction: a chronic inflammatory response. , 1974, Journal of biomedical materials research.

[11]  Felipe I. Tolentino,et al.  ABSORPTION AND RELEASE OF ANTIBIOTICS BY A HYDROPHILIC IMPLANT FOR SCLERAL BUCKLING , 1983 .

[12]  M. Refojo,et al.  HYDROGEL IMPLANT FOR SCLERAL BUCKLING: Long-term Observations , 1985, Retina.

[13]  C. Behling,et al.  Quantitative characterization of cells at the interface of long-term implants of selected polymers. , 1986, Journal of biomedical materials research.

[14]  C. Barr.  THE HISTOPATHOLOGY OF SUCCESSFUL RETINAL REATTACHMENT , 1990, Retina.

[15]  F I Tolentino,et al.  A HYDROPHILIC ACRYLATE IMPLANT FOR SCLERAL BUCKLING: Technique and Clinical Experience , 1981, Retina.

[16]  A. Behar,et al.  HISTOPATHOLOGIC FINDINGS FOLLOWING SCLERAL BUCKLING IN AN EYE 18 DAYS AFTER A CIRCLING-BUCKLING OPERATION WITH POLYETHYLENE TUBE WITH PARTICULAR REFERENCE TO THE AREA WHERE THE POLYETHYLENE TUBE INDENTED UNRESECTED AND UNDIATHERMIZED SCLERA. , 1964, American journal of ophthalmology.