A scleral buckle is a tried and true surgery that has been used to repair retinal detachments for decades.
A scleral buckle is a surgical procedure used to repair a retinal detachment by supporting the retina tears from the outside of the eye. A scleral buckle is a piece of silicone semi-hard plastic that the retina surgeon places around the outside of the eye like a belt. It is secured to the sclera or white part of the eye. It will be behind your eyelids, so, for the most part, it cannot be seen. The scleral buckle usually remains in place permanently.
In addition to the scleral buckle, cryopexy (freezing) or laser is applied to the retinal tear to seal it closed. This is a critical step in repairing the retinal detachment.
The combination of the scleral buckle (support from outside of the eye) and cryopexy or laser (treating inside of the eye) together work to repair the retinal detachment. Furthermore, to help drain the fluid under the retinal detachment, a gas bubble may be injected into the eye or subretinal fluid may be drained from outside of the eye.
All of these steps together help seal the retina to its proper position against the inside back wall of the eye.
Scleral buckling is performed when the following conditions are indicated:
The most common causes of retinal detachments are the formation of rhegmas or full-thickness tears in the retina. Rhegmatogenous detachments account for 90% of detachments, where using a scleral buckle may help treat the detachment.
Before scleral buckle surgery, patients will need to make arrangements for a ride after the procedure. Your doctor will notify you of any medications you will need to stop taking prior to surgery. Before surgery, your eye doctor may also advise limiting solids and liquids before the procedure.
Here is what you can expect during surgery:
Recovery time is anywhere from two to four weeks. Your doctor will provide aftercare instructions. This includes information on when you can resume taking prescription medications, as well as instructions for medication prescribed to treat post-surgery pain.
Typically, you’ll be able to go home the day of surgery, but you’ll need someone to drive you. Some pain is expected within the first few hours or days following the procedure. Your pain level may decrease within a few days, but you’ll continue to have redness, tenderness, and swelling for a few weeks after surgery. It takes about a month for the swelling and redness to go down all the way and for the eye to look almost back to normal.
You will need to wear an eye patch for the first day after surgery and apply antibiotic eye drops to prevent infection as well as anti-inflammatory drops. You will apply eye drops for up to six weeks after surgery.
Your surgeon may instruct you to place ice or cold pack over the eye for 10 to 20 minutes at a time to reduce swelling within the first few days of recovery. Be sure to cover the ice pack with a towel before applying to prevent ice burn on your skin.
Within the first two weeks, be sure to allow your eye to heal before engaging in strenuous activity. Within this time try to avoid exercise, heavy lifting, and cleaning. Your ophthalmologist may also restrict the amount of reading to reduce the amount of eye movement.
Some people can return to work one to two weeks after scleral buckling. This depends on how you feel and the type of work you do. You should stay at home longer if your job involves heavy lifting or a lot of computer work.
Contact your doctor right away if you notice any signs of complications after surgery, such as:
Other risks and complications associated with this surgery include: