Scleral Buckling Surgery for Retinal Detachment
A scleral buckle is a piece of silicone sponge, rubber, or semi-hard plastic that your eye doctor (ophthalmologist) places on the outside of the eye (the sclera, or the white of the eye). The material is sewn to the eye to keep it in place. The buckling element is usually left in place permanently.
The element pushes in, or "buckles," the sclera toward the middle of the eye. This buckling effect on the sclera relieves the pull (traction) on the retina, allowing the retinal tear to settle against the wall of the eye. The buckle effect may cover only the area behind the detachment, or it may encircle the eyeball like a ring. See a picture of a scleral buckle in place.
By itself, the buckle does not prevent a retinal break from opening again. Usually extreme cold (cryopexy) or, less commonly, heat (diathermy) or light (laser photocoagulation) is used to scar the retina and hold it in place until a seal forms between the retina and the layer beneath it. The seal holds the layers of the eye together and keeps fluid from getting between them.
Sometimes your eye doctor may inject a gas bubble into your eye to flatten the retina. He or she may also drain the fluid under the detached retina through a tiny hole in the sclera. If there is only a small amount of fluid, draining it may not be needed. The retina will pump it out.
Other facts about the surgery
What To Expect After Surgery
You may have some pain for a few days after the surgery. Your eye may be swollen, red, or tender for several weeks. Your eye doctor may put drops in your eye that prevent infection and keep the pupil from opening wide (dilating) or closing (constricting). You may have to wear a patch over the eye for a day or more.
Contact your doctor right away if you notice any signs of complications after surgery, such as:
Why It Is Done
Scleral buckling is effective in supporting a tear, hole, or break in the retina that has caused the detachment. It is rarely helpful on its own when scar tissue tugging on the retina has caused the detachment (traction detachment).
How Well It Works
Placing a scleral buckle reattaches the retina in most cases.1
Chances for good vision after surgery are higher if the macula was still attached before surgery. If the detachment affected the macula, good vision after surgery is still possible but less likely.
Scleral buckling poses some short-term and long-term risks. Most of these complications do not happen very often. The potential benefits of surgery usually far outweigh the risks.
The surgery may also affect your vision in other ways:
What To Think About
There are a few ways to repair a retinal detachment. The chance that each surgery type can help restore good vision varies from case to case. The cause, location, and type of detachment usually determine which surgery will work best. Other conditions or eye problems may also play a role in the decision.
You may need more than one surgery to reattach the retina if scar tissue from the first surgery grows over the surface of your retina.
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