Scleral buckling surgery is a common way to treat retinal detachment. It is a method of closing breaks and flattening the retina.
A scleral buckle is a piece of silicone sponge, rubber or semi-hard plastic that your eye doctor (ophthalmologist) places on the outside of the eye (the sclera, or the white of the eye). The material is sewn to the eye to keep it in place. The buckling element is usually left in place permanently.
The element pushes in, or "buckles," the sclera toward the middle of the eye. This buckling effect on the sclera relieves the pull (traction) on the retina, allowing the retinal tear to settle against the wall of the eye. The buckle effect may cover only the area behind the detachment, or it may encircle the eyeball like a ring.
By itself, the buckle does not prevent a retinal break from opening again. Usually extreme cold (cryopexy) or, less commonly, heat (diathermy) or light (laser photocoagulation) is used to scar the retina and hold it in place until a seal forms between the retina and the layer beneath it. The seal holds the layers of the eye together and keeps fluid from getting between them.
Sometimes your eye doctor may inject a gas bubble into your eye to flatten the retina. He or she may also drain the fluid under the detached retina through a tiny hole in the sclera. If there is only a small amount of fluid, draining it may not be needed. The retina will pump it out.
Other facts about the surgery
- The surgery usually takes place in a hospital. Detachments can usually be repaired on an outpatient basis (you go home the same day) in the hospital or in an outpatient surgical center.
- Local or general anesthesia may be used.
- Before the surgery, your eye doctor may patch both of your eyes and have you stay in bed to keep the detachment from spreading. Right before surgery, he or she will use eyedrops to dilate your pupils and may trim your eyelashes to keep them out of the way.
- A first-time surgery usually lasts 1 to 2 hours. Repeat surgeries or more complex detachments may take longer.
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