The first scleral buckle surgery to fix a retinal detachment was performed in 1953 and with a few refinements and modifications over the years it remains a reliable and effective way to reattach a detached retina.
Other surgeries to reattach the retina are pneumatic retinopexy, vitrectomy, or a combination of scleral buckling and vitrectomy.
Types of Retinal Detachments
Rhegmatogenous retinal detachment is the most common type of retinal detachment and it happens when there is a small tear or hole in the retina. This type of detachment happens in 90% of all cases of retinal detachment. The tear or hole allows the gel-like fluid in the center of the eye to seep behind the retina where it pushes the retina away from the back of the eye causing it to detach.
Tractional retinal detachment occurs when scar tissue grows on the retina pulling it away from the back of the eye. The most common cause of tractional retinal detachment is diabetic retinopathy in which blood vessels become damaged and cause scarring. Other causes are eye diseases, eye infections, and swelling of the eye.
Exudative retinal detachment is also caused by fluid building up behind the retina, but there are no retinal tears or holes in this type of retinal detachment. The most common causes of exudative retinal detachment are leaking blood vessels or swelling in the back of the eye. This type of retinal detachment can be caused by injury or trauma to the eye, tumors in the eye, or diseases that cause inflammation inside the eye.
How does a Scleral Buckle Work?
A small buckle is placed around the eye under the eye muscles. The buckle is tightened around the eye to reduce the diameter of the eye. Reducing the eye’s diameter creates slack and eliminates the tugging and pulling from the fluid that was detaching the retina.
A scleral buckle is a piece of silicone, semi-hard plastic that surrounds and secures the eye like a belt. It is secured around the white of the eye—the sclera. The buckle usually remains in place permanently.
Subretinal fluid is drained and the tears or holes in the retina are sealed. At this point a gas bubble may be placed in the eye. The gas bubble acts as a shield to prevent any further fluid from accumulating under the retina during the healing process.
The procedure can take about 45 minutes. Recovery time varies from person to person and can be anywhere from two to eight weeks. If a gas bubble was placed, there are specific post-surgical instructions that must be followed.