This condition requires immediate attention and often needs surgery to prevent permanent vision loss. One of the most effective treatments used for this condition is Scleral Buckling — a well-established surgical method to repair a detached retina and restore normal vision.
In this article, we will explore what Scleral Buckling is, why it’s performed, how it works, the recovery process, and what patients can expect after surgery. Everything is explained in simple and easy-to-understand language to help you gain a clear understanding of this important eye procedure.
Understanding the Retina and Retinal Detachment
To understand scleral buckling, it’s important to first know what the retina does.
The retina is a thin layer of light-sensitive tissue located at the back of the eye. It plays a crucial role in vision by converting light that enters the eye into electrical signals. These signals are then sent to the brain, which interprets them as images.
When the retina pulls away or detaches from its normal position, it leads to a condition called retinal detachment. This separation prevents the retina from working properly, and if not treated quickly, it can result in permanent vision loss.
Retinal detachment can happen for several reasons, but it most often occurs due to a tear or hole in the retina. This allows fluid from inside the eye to seep under the retina, causing it to lift away from its underlying layer.
Common Causes of Retinal Detachment
Retinal detachment can affect anyone, but certain factors increase the risk. Some of the most common causes include:
Aging: As people age, the gel-like substance inside the eye (called the vitreous) shrinks and can pull on the retina, leading to tears.
Severe Myopia (Nearsightedness): People with high myopia have longer eye shapes and thinner retinas, which are more prone to tears.
Eye Injuries: Trauma or accidents involving the eye can damage the retina and cause detachment.
Previous Eye Surgery: Surgeries such as cataract removal may slightly increase the risk.
Family History: Genetics can also play a role, as retinal detachment may run in families.
What Is Scleral Buckling?
Scleral Buckling is a surgical procedure designed to repair a detached retina. It has been used for many decades and continues to be one of the most reliable and successful treatments for retinal detachment.
In simple terms, scleral buckling involves placing a small piece of silicone material (called a “buckle”) around the white outer layer of the eye, known as the sclera. This buckle gently pushes the wall of the eye inward, reducing the pulling force on the retina and allowing it to reattach to the back of the eye.
The buckle acts like a supportive band that keeps the retina in place while it heals. Over time, the retina reattaches naturally, and the buckle usually remains permanently in place, although it is not visible or uncomfortable.
How Does Scleral Buckling Work?
The main goal of scleral buckling is to close the retinal tear and stop any fluid from leaking underneath the retina. Here’s how the procedure works in a step-by-step manner:
Anesthesia: The surgery is performed under local or general anesthesia to ensure comfort during the procedure.
Identifying the Retinal Tear: The surgeon examines the retina using a special microscope to locate any tears or holes.
Sealing the Tear: The tear is sealed using a freezing treatment called cryotherapy, or sometimes with laser treatment. This helps create a small scar that seals the retina to the underlying tissue.
Placing the Buckle: A soft silicone band or sponge is stitched to the outer wall of the eye (the sclera). The buckle indents the wall of the eye slightly, pushing it toward the detached retina.
Draining the Fluid: In some cases, the surgeon may drain fluid that has collected under the retina to allow it to settle back into position.
Closing the Eye: Once the buckle is in place and the retina is reattached, the surgeon closes the incisions with fine stitches.
The surgery typically takes between one to two hours, depending on the complexity of the detachment.
Who Needs Scleral Buckling?
Scleral buckling is generally recommended for patients who have rhegmatogenous retinal detachment, which is the most common type. This type occurs due to one or more retinal tears that allow fluid to pass through.
It is often used in:
Younger patients, especially those who have not had cataract surgery.
People with a single or multiple retinal tears.
Individuals with certain types of retinal detachments caused by trauma.
Your eye specialist will determine if scleral buckling is the best option based on the condition of your retina and other factors.
Benefits of Scleral Buckling
Scleral buckling offers many advantages, making it a trusted choice for retinal repair. Some key benefits include:
Proven Success Rate: This surgery has been used for decades with excellent long-term results.
Restores Vision: In many cases, vision can be significantly improved once the retina reattaches.
Permanent Solution: The buckle remains in place for life and continues to support the eye structure.
Suitable for Various Retinal Tears: It can be used even in complex cases involving multiple retinal holes.
Minimally Visible: The buckle is placed externally, so it does not affect the appearance of the eye.
Risks and Possible Complications
Like any surgical procedure, scleral buckling carries some risks. However, serious complications are rare when the surgery is performed by an experienced retinal specialist. Possible risks include:
Mild eye pain or redness after surgery
Infection or swelling
Increased eye pressure (glaucoma)
Bleeding under the retina
Double vision (temporary in most cases)
Need for additional surgery if the retina detaches again
Most patients recover well and experience significant improvement in their vision once healing is complete.
What to Expect After Surgery
Recovery after scleral buckling surgery is gradual, and proper care is essential for the best outcome.
Immediately After Surgery:
Your eye will be covered with a patch to protect it.
You might experience mild pain or discomfort, which can be managed with prescribed medications.
Vision may be blurry at first, but this usually improves over time.
During Recovery:
Eye drops will be given to prevent infection and reduce swelling.
It’s important to avoid heavy lifting, bending over, or any activity that could strain your eyes.
You’ll need to attend follow-up appointments so your doctor can monitor the healing process.
Vision Improvement:
Vision recovery varies from person to person. Some may notice improvement within a few weeks, while for others it may take several months. The goal of the surgery is to preserve vision and prevent further loss rather than to fully restore perfect sight.
How Long Does the Buckle Stay in the Eye?
The silicone buckle used in the surgery is designed to stay in the eye permanently. It becomes part of the eye’s outer structure and does not cause pain or affect the appearance. In rare cases, if it causes irritation or other problems, it can be safely removed later.
Alternatives to Scleral Buckling
While scleral buckling is highly effective, there are other surgical options available depending on the type of retinal detachment:
Vitrectomy: This involves removing the vitreous gel from inside the eye and replacing it with gas or oil to reattach the retina.
Pneumatic Retinopexy: A gas bubble is injected into the eye to press the retina back in place.
Your eye specialist will decide which treatment is most suitable based on the size, location, and severity of the detachment.
Living After Scleral Buckling Surgery
Most people return to their normal activities within a few weeks. However, it’s important to protect your eyes and follow the recovery instructions given by your surgeon.
Some helpful tips for maintaining eye health include:
Attend all follow-up visits on schedule.
Use eye drops exactly as prescribed.
Avoid rubbing or pressing on your eyes.
Wear protective glasses if recommended.
Eat a healthy diet rich in vitamins and antioxidants to support retinal health.
When to Seek Medical Attention
After the surgery, you should immediately contact your doctor if you experience any of the following symptoms:
Sudden loss or decrease in vision
Severe eye pain
Increased redness or swelling
Flashes of light or new floaters
Prompt treatment ensures that any issues are addressed early before complications develop.
Conclusion
Scleral Buckling remains one of the most trusted and successful methods for treating retinal detachment. It works by gently supporting the eye’s structure and allowing the retina to reattach naturally. With proper care and follow-up, most patients achieve good vision recovery and can return to normal activities.
If you are experiencing symptoms such as flashes of light, floaters, or a sudden shadow over your vision, it’s important to seek help from a qualified eye specialist immediately.
For expert care and advanced retinal treatment, Dr. Mandeep Lamba provides comprehensive evaluation and management for retinal detachment, ensuring that every patient receives the best possible outcome through personalized care and the latest surgical techniques.
