Scleral Buckling Surgery

Scleral buckling surgery is one option for treating retinal detachment. During this procedure, a very small piece of silicone band or sponge is placed on the outside of your eye and sutured permanently in place. This pushes the outer wall (sclera) of the eye inwards, closing the retinal break and allowing the retina to reattach.

One of the benefits of scleral buckling surgery is that the risk of developing a cataract after the surgery is much lower than the risk of cataract formation after vitrectomy surgery. There is also no entry of instruments into the eye, and usually there is no need to position face down after the surgery. However, because sutures are required to secure the conjunctiva during the surgery, there is usually more postoperative discomfort with a scleral buckle compared with vitrectomy or pneumatic retinopexy. These sutures are absorbable, but usually some pain medication is required for the first week after scleral buckling surgery.

Scleral buckle surgery is performed at Rockyview Hospital, and you will not need to stay in the hospital after your surgery. It is recommended that a friend or family member accompany you to the hospital on the day of your procedure. You will have a patch on the operated eye and will be unable to drive afterwards. The patch will be removed the day after your surgery on your post operative day 1 visit with your retinal specialist. Both general anesthesia and local anesthesia are options for this procedure, and can be discussed with the anesthetist at the time of your surgery.

Typically patients are seen 1 day, 1 week, and 1 month following their surgery. During the first two weeks after surgery there are a number of activities that are not recommended. These include driving, any activities requiring lifting more than 10 lbs, or getting water in your eye (including while bathing). Avoid any activities that would require bending at the waist. You should also avoid reading, using computers or mobile devices. Watching TV is ok, provided it is from a distance of 6 feet or more. Activities performed at a distance require far less eye movement or strain compared with activities done within arms length. Traveling by air during the first month after surgery is strongly discouraged. In some circumstances, an air bubble may be intentionally left in the eye during the surgery to facilitate healing. In these circumstances air travel is absolutely contraindicated until the air bubble has disappeared.

Scleral buckles are often used in younger patients with retinal detachments, as the consequences of cataract formation are more significant in young patients. The configuration and extent of the detachment are the primary factors in deciding whether to use a scleral buckle, vitrectomy, pneumatic retinopexy, or a combination of these techniques. Ultimately, if you are suffering from a retinal detachment, your retinal specialist will advise you on which of these options is the best for your eye.

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