What Happens After a Scleral Buckling Procedure?

One of the more serious eye conditions is a retinal detachment, when the light-sensing tissue at the back of your eye comes unmoored from its support. If not treated immediately, it can result in vision loss.

At Retina Specialists, our expert team of retinal ophthalmologists specializes in retinal conditions, and they offer treatment options for retinal tears and detachments that include scleral buckling. As many patients aren’t familiar with the procedure or what follows it, the team is taking this opportunity to get you in the know.

Looking through the eye

To understand what a scleral buckling procedure is, it helps to know something about the eye’s anatomy. The best way to visualize the anatomy is to move from front to back, just as light does.

Ambient light first encounters the eye’s surface. That surface is covered with a clear, curved membrane; the clearness permits light to enter, while the curvature of the cornea protects the eye while also focusing the incoming light.

The light passes through a fluid-filled “anterior chamber” and then through the pupil to the lens, which refines the light’s focus. Finally, it moves through another fluid-filled chamber called the vitreous, striking the light-sensitive retinal tissue at the back of the eye.

Behind the retina lies the optic nerve. The retina translates the focused light into electrical signals, using the optic nerve to send them to the brain. The brain then decodes the signals so you can “see” the image.

What is a retinal detachment?

Retinal detachment is an emergency situation where the retinal tissue pulls away from its normal position, separating it from the underlying blood vessels that provide oxygen and other nutrients to the eye. The longer the condition goes untreated, the greater the risk of permanent blindness in the affected eye.

A retina can detach for any of a number of reasons, including aging, a blow to the eye, inflammation, or some diseases such as diabetes. Sometimes there’s no obvious cause.

The detachment itself is painless, but it produces warning signs either before it occurs or if it’s advanced, including:

• The sudden appearance of visual floaters (dark specks in your vision)
• Flashes of light in one or both eyes (photopsia)
• Blurred vision
• Gradually reduced peripheral vision
• A curtain like shadow over your field of vision

If you experience any of these, call Retina Specialists to make an emergency appointment.

What is scleral buckling?

The only way to treat a retinal tear or detachment is with surgery. A scleral buckling procedure closes tears in the tissue and flattens the retina.

A scleral buckle can be made from silicone sponge, rubber, or a semi-hard plastic. Your ophthalmologist places the buckle on the outside of the eye (on the sclera, the white part of the eye) and sews it to the eye to keep it in place. The buckle usually is a permanent placement.

The material pushes in, or "buckles," the sclera toward the middle of the eye, which relieves the pull on the retina and allows the tear to settle against the wall of the eye. The doctor may use the buckle to cover only the area behind the detachment, or he may choose to encircle the eyeball like a ring.

By itself, the scleral buckle doesn’t prevent a retinal break from opening again, so the doctor uses extreme cold (cryopexy), heat (diathermy), or light (laser photocoagulation) to scar the retina, holding it in place until a seal forms between the retinal tissue and the layer beneath it. The seal both keeps the layers of the eye together and prevents fluid from getting between them.

In most cases, placing a scleral buckle reattaches the retina and prevents further vision loss.

Your chances for good vision following the surgery are higher if the macula (the central 2% of the retina, which registers your central vision) has remained attached. If the detachment affected the macula, while it’s still possible to retain good vision, it’s less likely.

After a scleral buckling procedure

You may have some pain and blurry vision in the affected eye following the procedure, and your eye may be swollen, red, and/or tender for several weeks. The doctor may put drops in your eye to prevent post surgical infection, as well as to keep the pupil from opening wide (dilating) or closing (constricting). They may also have you wear a patch over the eye for a day or more.

Since the buckle remains in place permanently, there’s no follow-up procedure to remove it. You will, however, have follow-up appointments with the doctor to ensure your eye is healing well.

If you’re experiencing any of the symptoms of a retinal detachment, you need to make an emergency appointment with Retina Specialists to protect your vision. Call us at any of our Dallas, Texas, area locations.