Scleral buckle for retinal detachment

The retina is a light sensitive layer of tissue at the back of the eye that functions like a screen, receiving sharp images that are then transmitted to the brain. Retinal detachment occurs when this layer separates from the underlying eye wall and its nourishing tissues. This condition can lead to a rapid decline in vision and, if left untreated, can cause permanent severe vision loss. Retinal detachment requires urgent medical intervention.

Scleral buckling is one surgical option for repairing retinal detachment. Its goal is to reattach the retina to its normal position by altering the shape of the outer eye wall. This procedure is suitable for certain types of retinal detachments, depending on the nature and location of the tears and the extent of the detachment. The surgeon will determine the most appropriate surgical approach after a thorough examination of the eye.

The surgery is typically performed under general anesthesia. During the procedure, the conjunctiva, the clear tissue covering the white part of the eye, is opened. The surgeon then locates the retinal tear or hole and treats it with cryotherapy (freezing), which creates a scar around the tear to seal it. Next, a flexible silicone band is sewn around the eyeball and secured to the eye wall. This band indents the eye wall, bringing it closer to the retina and reducing internal traction, thereby helping the retina reattach. In some cases, fluid accumulated under the retina may be drained. Finally, the conjunctiva is closed with dissolvable sutures.

Prior to surgery, a general medical evaluation may be required, including blood tests, an electrocardiogram (ECG), and a chest X ray, depending on your age and health status. It is important to inform your doctor about all medications you are taking, especially blood thinners, as their dosage may need adjustment or temporary discontinuation before surgery. You will be instructed to fast for several hours before the procedure. It is advisable to arrange for someone to accompany you.

As with any surgical procedure, scleral buckling carries potential risks, though they are uncommon. These complications can include bleeding, infection, recurrent retinal detachment, or the development of fibrous tissues in the retina and vitreous. Additionally, there may be changes in your eyeglass prescription, cataract formation (clouding of the eye's lens), increased intraocular pressure, or double vision. Your surgeon will discuss the specific risks and the rationale for choosing this method in your case.

After surgery, you may experience pain, swelling, and redness in the eye, and sometimes double vision, which usually resolve within a few weeks. Visual improvement can be gradual, and the extent of recovery depends on the retina's condition before surgery and the duration of the detachment. It is crucial to rest and avoid strenuous physical activity, including vigorous sports, and exposure to dust or dirt for the period specified by your surgeon. Protect the operated eye and avoid touching or pressing on it. Use prescribed eye drops as directed. Additionally, if a gas or air bubble was injected into your eye during the procedure, it is strictly prohibited to fly, travel to high altitudes, or receive nitrous oxide for anesthesia or pain relief until the bubble completely absorbs, as this can cause a dangerous increase in eye pressure. Tell any medical team that there is a bubble in your eye, and follow any head positioning instructions given by your surgeon.

Eye examinations are typically scheduled the day after surgery, one week later, and then one month later, with subsequent visits as needed. Adhering to all follow up appointments is important. You should seek urgent medical attention if you experience a fever above 38 degrees Celsius (100.4 degrees Fahrenheit), severe or persistent eye pain, sudden worsening of vision, or the appearance of a new shadow or curtain in your field of vision.