By Chirag Shah, MD, MPH; Courtney Crawford, MD
    Editors' Choice

    Drs. Chirag Shah and Courtney Crawford show the removal of a MiraGel implant that was extruding from the conjunctiva and intruding into the vitreous cavity. They first perform a 360° conjunctival perimetry and remove the implant, piece by piece. After observing fluid egress, an infusion cannula is inserted through the pars plana to stabilize the globe and an MVR blade is used to create an incision, followed by standard tocars. An endolaser is used to reinforce the area of intrusion and then the scleral defect is repaired with a tutoplast allograft. During air/fluid exchange, they observe air escaping from the scleral defect. To seal it, they employ silicon oil, creating an oil, tutoplast, scleral sandwich, allowing the tutoplast to fibrose and seal the defect without causing hypotony or endophthalmitis.