Scleral buckling is a type of eye surgery doctors use to treat detached retinas. A detached retina is a medical emergency that requires immediate surgery.

A detached retina is when the retina peels away, or detaches, from the supporting tissue at the back of the eye. The retina is a thin layer of light-sensitive cells at the back of the eye that helps people to see clearly.

Surgery is necessary to repair a detached retina. Scleral buckling is one option and involves using a small device, known as a scleral buckle, to hold the retina in place.

Read on to learn more about scleral buckling, including how it works and who may require it.

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Scleral buckling is one method doctors may use to treat a detached retina. The retina is the layer of cells that line the back wall of the eye. The cells sense light and send signals to the brain, which enables a person to see.

“Sclera” refers to the white outer layer of the eyeball. Scleral buckling is where surgeons attach small pieces of silicone, called buckles, to a person’s sclera.

Scleral buckling procedures are complex, and there are many different ways to carry out the surgery. Surgeons typically perform them after gaining significant experience. This allows them to prevent and deal with any surgical complications.

Learn more about the eyes and how they work.

If a person’s retina partially or completely lifts away from the back of their eye, they have a detached retina. A detached or torn retina can cause a person’s vision to be blurry. Having a detached retina may cause people to lose sight in their affected eye, and it is a medical emergency.

If a person thinks they may have a detached retina, they should seek immediate medical attention. People with a detached retina usually need urgent surgery to reattach it.

People who have a detached or torn retina may need scleral buckling surgery. The type of surgery a person requires for their detached retina depends on:

  • how much of a person’s retina is detached
  • the position of the detachment
  • if they have other eye conditions
  • if they have had glaucoma surgery

Anyone can have a detached retina. People are more at risk if they have:

  • diabetic retinopathy, a condition that affects blood vessels in the retinas of people with diabetes
  • myopia, or nearsightedness
  • a severe type of myopia known as degenerative myopia
  • posterior vitreous detachment, where the fluid at the center of a person’s eye pulls away from their retina
  • retinoschisis, where a person’s retina separates into two layers
  • lattice degeneration, or thinning of a person’s retina

One of the most common types of detached retina is rhegmatogenous retinal detachment (RRD). Age is the most common cause of RRD. Some other factors that make people more likely to have RRD include:

Scleral buckling surgery allows a surgeon to reattach a person’s detached retina. It involves closing any breaks in a person’s retina and making sure it remains attached after surgery.

During the surgery, surgeons place a small, flexible band around a person’s sclera. This band is known as a buckle. The band secures a small piece of solid or spongy silicone overlying the hole or tear of the retina. The surgeon attaches them to a person’s sclera, causing it to buckle inward.

Buckling pushes on the sclera of a person’s eye, moving them inward toward their retina. This facilitates healing and allows the retina to reattach.

Typically, the buckles stay in a person’s eye permanently after surgery. Surgeons may also use lasers or freeze treatments to repair any tears in a person’s retina.

Before surgery, doctors thoroughly examine a person’s eye to find all tears in their retina. Finding all the tears is important for successful scleral buckling surgery.

Staff will clean the area around a person’s eyes before the procedure takes place. To perform scleral buckling surgery, a surgeon can use either local or general anesthetic.

After scleral buckling surgery, a person’s eye may feel sore. Most people will be able to return home on the same day after the procedure. They should not drive themselves home. They may also need to:

  • wear an eyepatch for about a day
  • avoid some activities while their eye heals, such as:
    • heavy lifting
    • heavy exercise
  • attend a follow-up visit with a doctor to make sure their eye is healing correctly

People can ask a doctor if they have any concerns or questions after their surgery. They should seek professional medical advice if:

  • their vision seems worse
  • they have a lot of pain
  • they have a lot of swelling

A person’s recovery time after this type of surgery can vary from 2–6weeks.

One of the most common risks after scleral buckling is choroidal detachment. The choroid is a layer of blood vessels between the retina and sclera. Between 23–44% of people have choroidal detachment after scleral buckling. However, in most cases, it settles down naturally in about 2 weeks.

Other complications or side effects may include:

  • diplopia, or seeing double
  • refractive changes, or blurry vision
  • infections
  • strabismus, or where a person’s eyes do not line up together
  • glaucoma, where the optic nerve that connects a person’s eyes to the brain is damaged
  • anterior segment ischemia, or damage to the blood vessels around a person’s eye
  • motility disturbances, or eye muscle problems

Scleral buckling is a type of surgery doctors may use to repair detached retinas. Detached retinas are a medical emergency. Without prompt surgery to fix them, people may permanently lose sight in their affected eye.

Experienced surgeons perform scleral buckling surgery, which involves fixing small buckles to a person’s sclera. This secures the detached retina and allows it to heal.