Scleral Buckle

What is a scleral buckle surgery?

Scleral buckling is a surgical procedure that treats a retinal detachment, which happens when the retina of your eye pulls away from the tissues that support it. Retinal detachment is a medical emergency. Without treatment, you could lose your vision.

You might have a detached retina if you start seeing a larger number of floaters and flashes than usual or if you have the feeling that a curtain has fallen over your eye.

Scleral buckling means that your surgeon fits and secures a piece of silicone or sponge onto your sclera, the tissue that you know as the white of your eye. The buckle pushes into your eye and indents it. This pushes your retina back into the tissues that normally support it so it can reattach.

What does scleral buckle surgery treat?

Your surgeon may recommend this eye surgery if you have a rhegmatogenous (pronounced “reg-muh-TAH-jun-us”) retinal detachment. This type of retinal detachment is the most common.

Aging is the usual cause of this type of retinal detachment. Other risk factors include eye injuries, previous eye surgeries and being very nearsighted.

Your eye care specialist may also recommend scleral buckling if you’ve already had treatment for a detachment, but your retina has detached again.

How common is the scleral buckle procedure?

Scleral buckling, which is an older procedure, has become less common over the years as vitrectomy has become more common. The reason for this might be because scleral buckling may have a more difficult recovery.

But a scleral buckle, either alone or in combination with another procedure, may be the best treatment for your situation.

Factors in deciding what type of surgery you have include:

• What condition your vitreous is in.
• Whether or not you have your natural lens or an implanted lens.
• Whether or not you’re able to hold your head in a certain position after a procedure.

How should I prepare for a scleral buckle?

Before you have surgery, your ophthalmologist will speak with you about your medical history and your symptoms. You should tell your provider about every medicine you take, including any type of supplement or over-the-counter products.

Your provider will let you know when you should stop taking any medications. They’ll also let you know when you’ll need to stop eating and drinking the night before the procedure.

A scleral buckle surgery is usually an outpatient procedure. You’ll need a responsible driver to take you home.

What happens during a scleral buckle?

When you get to the medical center for scleral buckling:

• You’ll get a sedative through your vein (IV).
• You’ll also need some type of anesthesia for the surgery: local anesthesia (which numbs only your eye), regional anesthesia (which blocks pain to a larger part of your body) or general anesthesia (which puts you to sleep so you feel nothing). You need to be completely still during the procedure.
• Your surgeon will give you eye drops that make your pupils wider (dilates them) to make the back of your eye easier to see.
• Your provider will keep your eye open with an instrument called a speculum.
• They’ll make a cut (incision) in the conjunctiva or the transparent covering over the sclera. Once your sclera is exposed, the buckle is placed around your eye. The buckle may resemble a complete band or sponges that go on either side of a detachment.
• They may do additional treatments to make sure your retina stays in place. They could choose lasers or freezing.
• Your surgeon may also remove fluid from behind your retina.

How long does this procedure take?

Usually, a scleral buckle surgery takes an hour to an hour and a half.

What happens after scleral buckle surgery?

After the procedure:

• You’ll receive an antibiotic to prevent infection.
• You’ll get an eye patch to wear for the rest of the day and maybe the next.
• You’ll stay at the surgery center until you wake up and your driver can take you home.
• You’ll have to return the next day for a follow-up appointment.
• You’ll need to limit activities for a few days.
• You may need to take over-the-counter pain medication if your eye is sore.

What are the benefits of scleral buckle surgery?

Scleral buckle surgery treats retinal detachment, which is a very serious medical condition. Without treatment, you could have loss of vision.

How successful is scleral buckle surgery?

The success rate is as high as 80% to 90%, according to some estimates.

What are the risks or complications of this procedure?

No procedure is without risk. Possible complications of scleral buckle surgery include:

• Double vision.
• Bleeding in your eye.
• Infection.
• Becoming more nearsighted.
• Cataracts.
• Higher pressure in your eye (intraocular pressure).
• Another retinal detachment or tear.

What is the recovery time?

Your recovery time may last from two to four weeks or even a bit longer. Be sure to ask your provider for exact timelines on when you can:

• Take a shower or bath.
• Return to work or school.
• Begin driving.
• Do strenuous activities, like play sports or lift heavier things.
• Go swimming.

When should I call my healthcare provider?

If you’ve had a scleral buckle, call your provider or get medical help if:

• Your eye is swelling.
• Your eyesight gets worse.
• You have extreme pain.

A note from Cleveland Clinic

If you have a detached retina, your provider will want to treat it quickly. An untreated detached retina can lead to a loss of vision. One of these treatments for retinal detachment is scleral buckling or scleral buckle surgery. The buckle indents your eyeball so your retina stays in place and can heal.