Scleral buckle is a procedure used to repair a retinal detachment.

Scleral buckle is one of the several surgical procedures that can be used to fix a retinal detachment. The retina is the thin layer of nerve cells that lines the back of the eyeball. The retina functions like the film inside a camera – it receives the image that we see. A retinal detachment causes part of the vision to disappear. Reattaching the retina is necessary to restore the lost area of vision. Surgery to reattach the retina is similar to reattaching wallpaper that has come loose from a wall.

Scleral buckle surgery is outpatient surgery done in an operating room – typically in a hospital or ambulatory surgery center. The surgery is done using local or general anesthesia. The scleral buckle is a thin strip of silicone that looks like a belt. It is secured around the eyeball under the thin tissue that covers the eyeball (conjunctiva). It is placed behind the eyelids where it is not visible. The buckle indents the eyewall in toward the detached retina, much like a belt around our waist pushes in toward our belly. Essentially, it moves the wall of the eye closer to the detached retina – narrowing the space between the two layers that need to be together again. The effect would be similar to shifting the wall of a room closer to the loose wallpaper within the room – making it easier for the wallpaper to settle back where it belongs. The surgery usually involves the use of laser or cryotherapy to form a permanent adhesion (“spot weld”) between the retina and the wall of the eye.

Patients go home the day of surgery or the day after surgery. The first postoperative visit takes place the day after surgery, at which time postoperative instructions are given. Several different types of drops will be used by the patient at home for approximately one month. If an air or gas bubble was placed into the eye during surgery, it may be necessary for the patient to keep their head in a certain position (left side down, for example) as much as possible for two weeks after surgery. Some patients notice improvement in vision immediately after surgery, and for others improvement can take several months. Pain can be managed with prescription pain or nonprescription pain medications for several days. The recovery period usually lasts several weeks. Most patients do not resume normal activities for at least two weeks. The vision can continue to improve for six months after surgery.

Any surgery has some associated risk. Scleral buckle surgery has been utilized since the 1950's. Complications that could occur include infection, double vision, bleeding, and others. Some complications are more serious than others. Fortunately, serious complications are rare. As with any surgery, the surgeon and the patient must weigh the benefits of surgery against the potential risks.