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Scleral Buckle

introduction

What is Scleral Buckle Surgery?

Scleral buckle surgery is a well-established procedure used to treat retinal detachment, a severe eye condition where the retina pulls away from the underlying tissue. The retina plays a crucial role in vision by capturing light and sending signals to the brain, and when it detaches, it can lead to vision loss or blindness if left untreated.

This surgery involves placing a silicone band, called a scleral buckle, around the eye to provide external support and encourage the retina to reattach. By applying gentle pressure, the scleral buckle pushes the retina back into its normal position, preventing fluid from accumulating underneath and allowing the healing process to occur naturally. The procedure is highly effective and has been a preferred method for treating certain types of retinal detachments for decades.

Why is Scleral Buckle Needed?

Scleral buckle surgery is required when the retina detaches from its underlying support layers, leading to vision loss. If not treated in time, a retinal detachment can cause irreversible damage, leading to permanent blindness. This surgery is particularly beneficial for patients who experience:

  • Retinal tears or holes

that allow fluid to seep underneath, causing the retina to lift off.

  • Rhegmatogenous retinal detachment 

the most common type of detachment caused by age-related changes in the vitreous gel inside the eye.

  • Trauma-induced retinal detachment

 which can occur due to direct impact on the eye, sports injuries, or accidents.

  • High myopia (severe nearsightedness) 

which increases the risk of retinal detachment due to the elongation of the eyeball.

  • Previous eye surgeries

where complications may have led to retinal instability.

By reinforcing the eye’s structure and supporting the retina’s position, scleral buckling prevents further detachment and helps maintain vision stability.

Benefits of the Scleral Buckle Surgery

Scleral buckle surgery has several advantages that make it a preferred option for treating retinal detachment:

  • High success rate

in reattaching the retina and restoring vision.

  • Long-term stability

 as the buckle remains permanently in place without interfering with daily activities.

  • Preservation of natural eye structures

 since the procedure does not remove the vitreous gel, unlike vitrectomy.

  • Compatibility with other retinal treatments

such as laser photocoagulation or cryotherapy, to enhance retinal attachment.

  • Minimized risk of cataract formation

 which is a common side effect of vitrectomy-based retinal surgeries.

Preparation Before the Procedure

Before undergoing scleral buckle surgery, a comprehensive preoperative assessment is necessary. The preparation includes:

  • A complete eye examination

to determine the extent of retinal detachment and assess the health of the retina.

  • Retinal imaging tests,

such as optical coherence tomography (OCT) and fundus photography, to visualize the detachment in detail.

  • Reviewing medical history

to identify any underlying conditions that could affect surgery or healing.

  • Stopping blood-thinning medications

 such as aspirin or anticoagulants, if advised by the doctor to prevent excessive bleeding.

  • Fasting guidelines

if the procedure will be performed under general anesthesia.

Scleral Buckle Treatment Procedure

The scleral buckle surgery is performed in several steps:

  • Administration of anesthesia:

The patient receives local or general anesthesia to ensure comfort during the procedure.

  • Small incisions on the sclera:

The surgeon makes precise incisions in the white part of the eye to create space for the buckle placement.

  • Placement of the scleral buckle:

A flexible silicone band is positioned around the eye to support the retina’s reattachment.

  • Draining subretinal fluid:

If necessary, excess fluid beneath the retina is drained to allow better adherence.

  • Cryotherapy or laser treatment:

Retinal tears are sealed using a freezing technique (cryotherapy) or laser photocoagulation to reinforce the attachment.

  • Closing the incisions:

The surgeon carefully sutures the incisions, and an antibiotic ointment is applied to prevent infection.

Precautions and Care After the Procedure

Proper post-operative care is essential to ensure a successful recovery. Patients should:

  • Use prescribed eye drops

to reduce inflammation and prevent infection.

  • Avoid strenuous activities and heavy lifting

for at least a few weeks to prevent stress on the eye.

  • Wear an eye shield at night

to prevent accidental rubbing.

  • Adhere to head positioning guidelines

 if recommended, to help fluid drainage and healing.

  • Attend follow-up visits

to monitor progress and detect any complications early.

Result of Scleral Buckle Treatment

Most patients notice an improvement in vision within a few weeks. However, some may require additional treatments, such as vitrectomy, if complications arise. With proper care, scleral buckle surgery successfully prevents further detachment and stabilizes vision.

Types of Retinal Detachments Treated with Scleral Buckle

Scleral buckle surgery is effective for various types of retinal detachments, including:

  • Rhegmatogenous detachment

caused by retinal tears and fluid accumulation.

  • Tractional detachment

due to scar tissue pulling on the retina, often seen in diabetic retinopathy.

  • Exudative detachment

 resulting from fluid leakage beneath the retina due to inflammation or tumors.

Scleral Buckle vs. Vitrectomy – Which is Better?

Scleral buckle and vitrectomy serve different purposes:

  • Scleral buckle is ideal for simpler retinal detachments

particularly in younger patients, as it preserves the vitreous gel.

  • Vitrectomy is better suited for complex cases

such as those involving severe traction or multiple retinal breaks.

Risks and Complications of Scleral Buckle Surgery

While highly effective, scleral buckle surgery carries some risks, including:

  • Infection

  • Increased intraocular pressure (glaucoma)

  • Double vision

  • Bleeding inside the eye

  • Need for additional surgery in rare cases

Success Rate and Long-Term Outcomes of Scleral Buckle Surgery

The surgery has an 80-90% success rate, with most patients experiencing stabilized vision and reduced risk of recurrence. Regular eye check-ups help maintain long-term retinal health.

Why Choose Dr Agarwals Eye Hospital for Scleral Buckle Surgery?

Dr Agarwals Eye Hospital is a best choice due to:

  • Expert retinal specialists

  • Advanced surgical technology

  • Personalized patient care and follow-up

  • High surgical success rates

 

 

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