Treatments
Overview
Intravitreal Injection
Laser Treatments
Vitrectomy
Scleral Buckle
Cryotherapy
B-scan Ultrasonography
Optical Coherence Tomography
Fluorescein Angiography

Scleral Buckle

What is a Scleral Buckle?
Scleral buckles are used in the repair of Retinal Detachments.  The scleral buckle is similar to a belt that surrounds the eye and indents the wall of the eye inward, both providing a solid foundation for the retina and relieving any tension that may be present on the retina from the vitreous. The buckle is made of silicone and is attached to the wall of the eye by sutures and designed to be permanent. The scleral buckle can be placed by itself or used in combination with a Pars Plans Vitrectomy.
 
What are the advantages of a Scleral Buckle?
Each retinal detachment is different and the specific characteristics will determine which surgical approach is best. Scleral buckles can be placed around the eye without the need to make incision into the eye itself reducing some of the risks associated with Pars Plana Vitrectomy. Scleral buckles used alone are ideal for young patients who have less vitreous degeneration and have not yet begun to develop cataracts. 
 
How is the surgery performed?
The surgery involves making incisions in the skin of the eye, the conjunctiva, and exposing the wall of the eye. The muscles that control eye movements are isolated, and in-between each muscle a suture is placed to hold the scleral buckle in place. The scleral buckle is placed around the eye, underneath the eye muscles, and through the sutures. After tightening, the wall of the eye will indent, flattening its curvature, and promoting retinal re-attachment.
 
When a scleral buckle is used alone, without a vitrectomy, the retinal tears are treated with Cryotherapy to forma a scar that causes the retina to adhere to the underlying tissue. The sub-retinal fluid is often removed by making a small incision in the wall of the eye to allow the fluid to drain out of the eye, termed external drainage. 
 
What are the risks associated with Scleral Buckle surgery?
Similar to other procedures the risk of infection is present as well as the risk of a retinal re-detachment, developing elevated eye pressure (glaucoma), and scarring of the retina. While all possible measures are taken to reduce these risks as much as possible they can never be zero. It is very important to weigh the risks with the benefits from the surgery when making the decision for surgery.
 
What is the recovery?
Scleral buckling is a major surgery for the eye and care must be taken during recovery to provide a good environment for the eye and retina to heal. It is important to avoid any water in the eye for the first week after surgery to allow the incisions to heal and limited physical activity is necessary for 1 month after surgery to give the eye time to strengthen. Occasionally, a small gas bubble is placed to support the retina from the inside and if necessary positioning will be needed 7-10 days to keep the bubble in contact with the damaged portion of the retina.
Dr Kruti Dajee Dr Jawad Qureshi Dr Johnathan Warminski