Patient Education
Scleral Buckle
Outpatient surgery · about 60–90 minutes
A scleral buckle repairs a retinal detachment from the outside of the eye. A soft silicone band is sewn onto the white of the eye and gently indents the wall inward, relieving the pull of the vitreous gel on the tear and bringing the eye wall back into contact with the retina.
A scleral buckle repairs a retinal detachment from the outside of the eye. A soft silicone band is sewn onto the white of the eye and gently indents the wall inward, relieving the pull of the vitreous gel on the tear and bringing the eye wall back into contact with the retina. The band stays in place permanently, hidden beneath the tissue, and cannot be seen or felt once healing is complete. It is particularly well suited to younger patients and to detachments with tears in the far periphery.
What to Expect
Before
This is outpatient surgery, usually under local anesthesia with sedation, though general anesthesia is used more often for buckles than for vitrectomy because of the manipulation involved. You will need to fast beforehand and arrange a ride home.
During
The surgeon opens the thin membrane covering the white of the eye, identifies the tear, and treats it with cryotherapy or laser. The silicone band is then sewn onto the eye wall and tightened to the right degree of indentation, and any fluid under the retina may be drained. The covering membrane is closed with dissolving stitches.
After
Expect a considerably more uncomfortable first week than after vitrectomy: a red, swollen, achy eye, often with double vision at first, and the sensation of stitches. This settles, but it is more of an ordeal in the early days than patients expect.
Recovery & Restrictions
- Plan for real discomfort in the first week. Your surgeon will prescribe pain medication — take it rather than trying to tough it out.
- The eye will be very red and the lids swollen. Cool compresses help.
- Double vision in the first days or weeks is common as the muscles around the eye recover from being handled, and it usually resolves.
- Buckling changes the shape of the eye, so your glasses prescription will change — usually toward more nearsightedness. Wait until your surgeon says the eye is stable before getting new glasses.
- Avoid swimming, heavy lifting, and strenuous activity for several weeks as directed.
- If a gas bubble was also placed, the positioning and air travel restrictions apply.
Risks & Side Effects
Refractive change
Indenting the eye lengthens it, which makes the eye more nearsighted and can introduce astigmatism. This is expected and is corrected with glasses once the eye stabilizes.
Double vision
Usually temporary from handling the eye muscles, but occasionally persistent and needing prism glasses or muscle surgery.
Buckle infection or exposure
Uncommon, and can occur years later. It presents as a red, irritated, discharging eye and is treated by removing the band, which is usually possible without the retina re-detaching once healing is well established.
Failure of the repair
The retina can re-detach, from a missed tear, a new tear, or scar tissue. Further surgery is then needed.
Fluid under the retina or in the choroid
Fluid can collect during or after the operation, usually settling on its own but sometimes delaying recovery.
Raised eye pressure
Can occur in the early period and is managed with drops.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.