# Challenges in Diagnosing Extruded Hydrogel Scleral Buckle Mimicking an Orbital Abscess: A Case Report

## TL;DR

A patient with a long-term hydrogel scleral buckle implant developed symptoms resembling an orbital abscess, highlighting the need for accurate diagnosis.

## Contribution

This case report highlights the rare but important challenge of diagnosing hydrogel explant complications mimicking abscesses.

## Key findings

- A hydrogel scleral buckle extrusion mimicked an orbital abscess in a 72-year-old patient.
- CT scans confirmed the presence of an abscess and preseptal cellulitis.
- The case emphasizes the need for careful differential diagnosis in patients with long-term hydrogel implants.

## Abstract

In this case report, we present an unusual complication linked to a hydrogel explant in a 72-year-old male presenting to the emergency department with persistent left eye pain, redness, and discharge for one month. The patient had a history of retinal detachment in 1989, which was managed with scleral buckle surgery and gas injection. Initial examination revealed an extruding scleral buckle in the superior temporal region, along with signs of an infection. CT scans revealed a 1.9 × 1.2 × 3.8 cm abscess accompanied by preseptal cellulitis. This case report highlights the importance of how hydrogel scleral buckle explants may mimic the presentation and symptoms of an abscess as a long-term complication. Nevertheless, there have been several reports of long-term issues associated with the expansion of the hydrophilic hydrogel material. This case report further illustrates how complications linked to hydrogel explants can resemble abscess symptoms, underscoring the significance of accurate diagnosis and appropriate management.