Scleral Buckle in retinal detachment
Scleral buckle is the preferred surgical technique for treating uncomplicated rhegmatogenous retinal detachment in young patients who still have a natural, transparent lens. Scleral buckle is a surgical procedure in which a sponge or band is sutured externally 180 or 360 degrees on the walls of the eye creating an indentation or internal depression. The objectives of this procedure are to close retinal tears by positioning the wall of the eyeball closer to the retina and to reduce the traction of the internal gel that led to the retinal detachment.
Undergoing scleral buckle has multiple advantages. It is a procedure performed outside of the eye, which presents a lower risk of developing an intraocular infection, costs less than a vitrectomy, and has an 84% success rate. The risk of the formation of a cataract is minor and usually the patient does not need to stay in a special position after surgery. Visual recovery will depend on whether the central part of the retina (macula) was involed and the time it was detached.
Scleral buckle is performed in an operating room using local or general anesthesia depending on the case. Before the surgery, the patient will receive drops to dilate the pupil so that the surgeon can visualize the retina correctly. The scleral buckle surgery can last between 1 and 2 hours depending on the complexity of the case or if it is a surgery combined with a vitrectomy.
Photo: "Dr. Moreno perfoming a scleral buckle procedure".
What to Expect After Surgery
It is normal to feel mild to moderate pain for several days after surgery, especially when you perform eye movements (such as looking from side to side). The eye may be inflamed, red or tender for several weeks and it is important to use antibiotics and anti-inflammatories to prevent infections and facilitate recovery.
However, contact your doctor immediately if you experience any of the following symptoms after surgery: suddenly decreased vision, pain that increases over time instead of improving, increased secretion or any new floaters, luminous flashes or changes in your field of vision (such as seeing a black curtain that increases in size).
Scleral buckle has short and long-term risks. Fortunately, the majority of the cases do not typically have complications. The most common cause of a retinal detachment after surgery is due to the formation of membranes on the retina, which occurs in about 10% of cases. Scleral buckling can generate changes in eyeglass prescription, double vision or increase intraocular pressure that improve with time.