Chronic Macular Oedema as a Late MIRAgel-Related Complication
, Christina S. Lim 1, Hardeep-Singh Mudhar 2, Evangelos Lokovitis 1 and Raghavan Sampath 1
Round 1
Reviewer 1 Report
Very good , practical and informative paper, topic of the paper seems to me extremely significant , we face that kind of scleral buckle ( miragel) very frequently , they were used in our region ( east Europe) quite often in the past so idea and scientific proof which was show by authors that simple and complete removing of the implants ( which can be sometimes not possible ) is enough for resolution od cmo is very valuable message for clinical practice.
ready for publish
Author Response
Response: Thank you for the comments from the reviewer and we hope the reviewer has enjoyed reading our manuscript
Reviewer 2 Report
Dear colleague
What was the postoperative follow-up? Is it only 1 week after the surgery (line 78)? Please add it in the method if the follow-up was longer.
Knowing the difficulty of remove all of the scleral buckle hydrogel, why not perform routine postoperative MRI to prevent a risk of future inflammation?
Author Response
What was the postoperative follow-up? Is it only 1 week after the surgery (line 78)? Please add it in the method if the follow-up was longer.
Response: The patient was being followed-up by the retina and the oculoplastic team for up to 4 months after his first operation to remove the MIRAgel® scleral buckle. Patient remained asymptomatic and had no new ophthalmic symptoms or concerns. This has been added to the manuscript.
Knowing the difficulty of remove all of the scleral buckle hydrogel, why not perform routine postoperative MRI to prevent a risk of future inflammation?
Response: After the first operation to remove the MIRAgel scleral buckle, the patient recovered well throughout the postoperative follow-up period and was subsequently discharged. As the patient represented with chronic macular oedema, we performed the second operation to remove all the remaining fragments of the hydrogel as safely as possible. We felt that any further exploration and removal would risk damages to the surrounding orbital structures such as the perforation or rupture of the globe and extraocular muscles. For this reason, we did not see further benefit of a postoperative MRI scan, especially when the initial symptoms from the hydrogel resolved and macular oedema did not recur.
