Scleral Buckle
Scleral buckling or scleral buckle surgery is a type of out-patient ocular procedure to close a retinal break or tear, both for acute and chronic retinal detachments. Retinal detachment happens when part of your retina detaches from the rest of your retina and eye, causing that portion of your eye to not function properly and results in partial or full vision loss.
What is Scleral Buckle Surgery?
There are two ways to perform this surgery, one is under anesthesia, the other is through drops and injections to make sure you do not feel anything while you are still awake. Either approach your surgeon takes, you will not feel any pain during surgery.
During the procedure your surgeon cut a small incision into your eye and will carefully attach a piece of silicone or a sponge onto the sclera (white of your eye), at the spot of the retinal tear or break. The “buckle” is designed to repair that detachment by pushing the sclera toward the retinal tear or break.
Retinal detachment surgery usually also involves the use of cryotherapy or laser photocoagulation. The laser or cryotherapy forms a permanent adhesion around the retinal break and prevents further accumulation of fluid and re-detachment.
Once complete, your doctor will seal your retina back together likely using a freezing device that scures the retina to the inner wall of the eye. Then place a very small band, known as a buckle around the outside of your eyeball so your retina stays in place.
Once secured, fluid in your eye may need to be drained. An antibiotic ointment may be applied to your eye to help prevent infection and you will leave with an eye patch.
Post Surgery
You will return home the same day after your procedure, so you will need someone to drive you home.
Your surgeon may prescribe antibiotic eye drops to help prevent infection. It is normal for your eye to be sore after surgery, and mild discomfort can usually be relieved with over-the-counter pain medication, unless your surgeon provides other instructions.
Your eye will be covered with a protective patch after surgery. Please leave the patch in place until your post-operative appointment the following day whenever possible. If the patch becomes too irritating or uncomfortable, it may be removed 8 hours after surgery. Because a numbing solution was used during your procedure, it may be difficult to blink normally right away. Ideally, the patch should remain in place until you are able to blink normally.
Once the patch is removed, it is common to experience redness, bruising, tearing, discharge, or the sensation that something is in your eye (foreign body sensation).
Do not miss your post-operative appointment with your surgeon the following day. This visit is an important part of your recovery and allows your surgeon to monitor your healing.
If you experience decreasing vision, increasing eye pain, or swelling around your eye, call our triage line immediately at (615) 983-6000.
Potential Risks
With any operative procedure there is always an uncommon underlying risk of complication. Risks may depend on your age, overall health, and specifics of your detachment. Here are the potential risks:
- The RD returns and you need another surgical repair
- Proliferative vitreoretinopathy
- Detachment of the eye layer beneath your retina
- Hemorrhage in your eye
- Retinal incarceration
- Infection
- Increased nearsightedness
- Cataracts
- Increased eye pressure
- Double vision
- New retinal tears
Common Questions
You most likely experienced a retinal detachment either spontaneously or due to trauma to the eye. RD’s may be associated with aging, another underlying eye condition, such as uveitis, diabetes, nearsightedness, or a prior cataract surgery. Once you reattach the retina in surgery, it should restore much if not all your temporarily lost sight. If the detachment is left untreated it could result in permanent vision loss.
The buckle is usually left in place permanently and does not need a separate procedure for removal. It is designed to be a long-term support for the retina.
In most cases, the buckle does not cause discomfort or interfere with daily activities. It cannot be felt or seen externally after everything has healed. However, a minority of patients could experience mild irritation or changes in vision, which your doctor will monitor and may discuss with you if adjustments are necessary.
