View abstract

This abstract is assigned to session Poster session

Title	Cryoextraction as a surgical technique for removal of episcleral Miragel buckle
Abstract Nr.	P111

Purpose	To describe the surgical technique and the advantages of removal of an episcleral Miragel buckle by cryoextraction.
Methods	A 72-year old man was referred to the ophthalmology department for chronic purulent conjunctivitis due to a protruding episcleral Miragel buckle in the right eye. The buckle elements were removed by surgical cryoextraction. Postoperatively, MRi scan of the orbit was performed to identify remnants of the Miragel buckle in the orbital cavity.
Results	The protruding episcleral Miragel buckle was removed under general anesthesia. During this surgery, the fibrous capsule surrounding the implant was dissected and the sutures were cut out. The cryoprobe tip was applied for 10 to 20 seconds on the Miragel surface. While applying traction on the cryoprobe, the surgeon pushed the implant outwards with a Freer periostal elevator. The implant could be removed in several large fragments. Our patient recovered uneventfully. Postoperative MRi scan showed a complete removal of the Miragel implant.
Conclusion	The Miragel buckle is difficult to remove by using only forceps, because of the extreme friability and gel-like consistency. The surgical technique of cryoextraction offers many advantages. First of all, it reduces fragmentation during surgery. The material is less friable when its water content is frozen, so the extracted fragments tend to be larger. Secondly, manipulations with sharp-tipped instruments alongside a frequently thinned sclera are avoided. Thirdly, the procedure duration seems to be reduced, shortening general anesthesia time.

Authors 1

Last name	ROELS
Initials	D
Department	Dept of Ophthalmology, Ghent University Hospital
City	Ghent

Authors 2

Last name	De Craene
Initials	S
Department	Dept of Ophthalmology, Ghent University Hospital
City	Ghent

Authors 3

Last name	Bauters
Initials	W
Department	Dept of Radiology, Ghent University Hospital
City	Ghent

Authors 4

Last name	Kestelyn
Initials	P
Department	Dept of Ophthalmology, Ghent University Hospital
City	Ghent