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.
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:
that allow fluid to seep underneath, causing the retina to lift off.
the most common type of detachment caused by age-related changes in the vitreous gel inside the eye.
which can occur due to direct impact on the eye, sports injuries, or accidents.
which increases the risk of retinal detachment due to the elongation of the eyeball.
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.
Scleral buckle surgery has several advantages that make it a preferred option for treating retinal detachment:
in reattaching the retina and restoring vision.
as the buckle remains permanently in place without interfering with daily activities.
since the procedure does not remove the vitreous gel, unlike vitrectomy.
such as laser photocoagulation or cryotherapy, to enhance retinal attachment.
which is a common side effect of vitrectomy-based retinal surgeries.
Before undergoing scleral buckle surgery, a comprehensive preoperative assessment is necessary. The preparation includes:
to determine the extent of retinal detachment and assess the health of the retina.
such as optical coherence tomography (OCT) and fundus photography, to visualize the detachment in detail.
to identify any underlying conditions that could affect surgery or healing.
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.
The scleral buckle surgery is performed in several steps:
The patient receives local or general anesthesia to ensure comfort during the procedure.
The surgeon makes precise incisions in the white part of the eye to create space for the buckle placement.
A flexible silicone band is positioned around the eye to support the retina’s reattachment.
If necessary, excess fluid beneath the retina is drained to allow better adherence.
Retinal tears are sealed using a freezing technique (cryotherapy) or laser photocoagulation to reinforce the attachment.
The surgeon carefully sutures the incisions, and an antibiotic ointment is applied to prevent infection.
Proper post-operative care is essential to ensure a successful recovery. Patients should:
to reduce inflammation and prevent infection.
for at least a few weeks to prevent stress on the eye.
to prevent accidental rubbing.
if recommended, to help fluid drainage and healing.
to monitor progress and detect any complications early.
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.
Scleral buckle surgery is effective for various types of retinal detachments, including:
caused by retinal tears and fluid accumulation.
due to scar tissue pulling on the retina, often seen in diabetic retinopathy.
resulting from fluid leakage beneath the retina due to inflammation or tumors.
Scleral buckle and vitrectomy serve different purposes:
particularly in younger patients, as it preserves the vitreous gel.
such as those involving severe traction or multiple retinal breaks.
While highly effective, scleral buckle surgery carries some risks, including:
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.
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