Scleral buckling surgery is one of the ways
to treat retinal detachment. It is a method
of closing breaks, bringing the two layers
of the retina back together, and getting rid
of fluid under the retina.
A scleral buckle is produced by a piece of
silicone sponge, rubber, or semi-hard
plastic that your eye doctor
(ophthalmologist) places on the outer layer
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.
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 close the break and
prevent more fluid from passing through it
during surgery. He or she may 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 layer under the retina will
absorb it.
Other facts about the surgery
The surgery takes place in a hospital.
Detachments can usually be repaired on an
outpatient basis (you go home the same day)
in the hospital or in an outpatient surgical
center.
Local or general anesthesia may be used.
A first-time surgery usually lasts 1 to 2
hours. Repeat surgeries or more complex
detachments may take longer.
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.
Why It Is Done
Scleral buckling is effective in repairing a
tear, hole, or break in the retina that has
caused the detachment. It is rarely helpful
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. The overall rate of
reattachment success rises to above 90% with
more than one procedure.
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.
The surgery takes place in a hospital.
Detachments can usually be repaired on an
outpatient basis (you go home the same day)
in the hospital or in an outpatient surgical
center.
