About Scleral Buckling Surgery
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What is Scleral Buckling?
Sclera buckling refers to a surgical procedure that involves a piece of silicone plastic or sponge being sewn onto the sclera at the location of a retina tear, for the purpose of pushing the sclera towards the retinal tear. The buckle pushes the sclera against the retina until the tear is sealed by scar tissue. It also prevents further retinal detachment by preventing fluid leakage.
Why is Scleral Buckling done?Scleral buckling is used to reattach the retina and is effective in supporting a tear, hole, or break. It is performed to reestablish the anatomic proximity between the separated retina and its underlying tissue. An acute retinal detachment is considered an ophthalmologic emergency that could rapidly progress to irreversible loss of vision in the affected eye if not treated.
ProcedureThe scleral buckling procedure is performed in an operating room, under either general or local anesthesia depending on the doctor’s judgment. Patients are given eye drops just before the procedure, to dilate the pupil and allow better access to the eye. The patient is then put under anesthesia, and after the eye is numbed, the eye membrane is cut to expose the sclera. In instances where the surgeon’s view of the retinal detachment is blocked by inflammation or bleeding, a vitrectomy may be performed before sclera buckling.
Expectations after SurgeryUpon surgery, one may experience pain for a few days. The eye may be red and swollen or even tender for a few weeks. Eye drops are often administered to prevent infections and keep the pupil from dilating and constricting. Additionally, one may have to wear an eye patch for a day or two after surgery.
However, complications may arise soon after surgery. The patient should contact the doctor in case they develop one or more of these signs:
- Decreasing vision.
- Swelling around the eye.
- Increasing redness.
- Increasing pain.
- Any discharge from the eye.
- Any new floaters, flashes of light, or changes in your field of vision
The success of scleral buckling is determined by the extent of initial macular involvement. The most crucial factor affecting the success of restoring visual acuity is the presence or absence of macular involvement.
There are several factors that also predict poor visual function such as:- Age (>70 y)
- Macular detachment occurring more than 7 days prior to surgery
- Severe proliferative vitreoretinopathy
- Intraoperative hemorrhage
What to think aboutThere are several ways in which retinal detachment may be corrected. Each method can help restore good vision. The results vary depending on the cause, location, and type of detachment, which determine which type of surgery to be employed.
Risks : There are both short-term and long-term risks associated with Scleral buckling. In most cases, these complications never arise, but it is important to be aware of them. These risks include:
Proliferative vitreoretinopathy (PVR), which is a type of scarring on the retina that may cause the retina to detach again. PVR calls for additional treatment, which may include vitrectomy surgery.
Detachment of the choroid, which is part of the tissue that forms the eyeball, or swelling in the retinal area may delay healing.
People with glaucoma face the risk of the sclera buckle pressure raising the fluid pressure inside the eyeball.
There are chances of the eye developing infections. Antibiotics and corticosteroids may be needed to treat the infection and reduce discharge from the eye.
The buckling device might cause irritation and discomfort as a result of rubbing on to other parts of the eye. If this becomes the case, it may have to be removed.
Impaired vision might also be caused by bleeding in the eye.
There are other ways in which the surgical procedure may affect your vision. Such include:
Your vision may be affected as a result of the sclera buckling changing the natural shape of your eye. The change in shape may cause a refractive error that could affect your vision. In case this occurs, it may be corrected using glasses or contact lenses.
Misaligned eyes known as strabismus and double vision known as diplopia may result from improper movement of the eye muscles that may result from the presence of the sclera buckle.
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