Seven cases in which long-term complications developed from swelling of the MAI hydrogel intrascleral buckling implant are reported herein. Micro-Fourier transform infrared spectroscopic analysis of two recovered implants demonstrated the occurrence of chemical changes leading to increased swelling. Clinical problems with the implants appeared 7 to 11 years after surgery, suggesting the need for periodic, long-term follow-up. It is possible that the present-day MIRAgel implant, which has the same chemical composition as the MAI implant, may require similar precautions.