Scleral buckle surgery comes with low risks, although doctors recommend several weeks of care to avoid some complications. Know more about the procedure.
Scleral buckle surgery is often times known as the scleral buckling surgery. This is a procedure to repair the retinal detachment. It consists of the introduction of a silicone material to bring this tissue to its original position.
Although there are other alternatives, this is one of the most used by ophthalmologists. Below you can find the most outstanding aspects of the surgery. Keep reading!
Why is the retina detached?
This structure has the appearance of a thin layer that occupies the back of the eye, but from a microscopic point of view it is highly complex. Thanks to the retina we can see images clearly, so any damage causes permanent sequelae.
There are many mechanisms involved in retinal detachment and in all of them there is an accumulation of fluid (called the vitreous humor) behind the structure. Gradually this leads to loss of blood supply, which results in tissue death.
Detachment can happen spontaneously in some people with risk factors. The most important are the following:
- Age over 50 years.
- Diabetes mellitus.
- Having a personal or family history of retinal detachment.
- Having been treated with a previous ophthalmological procedure.
- Diabetic people have a higher risk of retinal detachment. Diabetes is a disease that alters the circulation of the small vessels, so it can affect the arteries of the retina.
How does scleral buckle surgery work?
According to a Texas Retina Associates publication, scleral buckling surgery involves the insertion of a silicone band or sponge in relation to the sclera. This last structure is the white part that is seen in all eyes around the iris.
This causes a slight increase in pressure and displacement of the intraocular structures to bring the retina to its original site. The procedure requires a few incisions on the outer surface of the eye to place the material.
The treating physician may perform some additional techniques to prevent recurrence of the disease. The most widely used are laser photocoagulation and cryopexy. In both cases, scar tissue is produced that allows the ruptures in the injured tissues to be sealed.
Previous preparation
Like all surgical procedures, there is usually a short preoperative stage that consists of the following:
- Stay in bed to avoid sudden movements while waiting for the start of the intervention.
- The doctor or nurse may trim the eyelashes a little and put in drops with medicine that dilate the pupil.
- Administration of local or regional anesthesia. This depends on the patient and the clinical severity.
How is it the procedure?
Depending on the severity of the retinal detachment, scleral buckling surgery may take at least 1 to 2 hours. The general steps are as follows:
- Making an incision in the sclera.
- Placement of the silicone material.
- Suture of the latter to prevent it from moving.
- Drainage of accumulated fluid behind the retina.
It is also possible to carry out the complementary procedures mentioned in the previous section, despite the fact that each of them has its own technique.
Expectation and recovery after scleral buckling surgery
The effectiveness of this procedure is usually very good, despite the fact that there are some complications that we will mention in the next section.
The first days of recovery are characterized by some local pain with constant redness and tearing. These symptoms lessen as the days go by.
In addition, the doctor may carry out other indications, such as the following:
- Keep relative rest, that is, not with absolute prostration.
- Use a patch after the procedure.
- Apply antibiotic drops periodically.
- Consuming pain relievers, such as ibuprofen.
- Do not drive and avoid carrying heavy objects.
- Do not travel by plane.
- Wear sunglasses.
However, as the weeks go by, it will be necessary to go to consultations with the treating doctor to verify the effectiveness of the procedure performed.
What are the risks?
Although rare, this procedure can cause complications in the first few weeks. The most important conditions are the following:
- Infections.
- Waterfalls.
- Glaucoma.
- New retinal detachment.
For this reason, it is advisable to go to the ophthalmologist in case of presenting loss of visual acuity or when viewing lights or foreign objects. Swelling around the eye and pain that increases are other warning signs.
Therefore, scleral buckling is not without risks, since it is a procedure that affects the eyeball. You have to be attentive to the warning signs.
Scleral buckle surgery is an effective option for an emergency
Retinal detachment is a medical emergency that can cause permanent blindness. In case of presenting any of the symptoms related to it, it is necessary to go to an ophthalmology service as soon as possible.
Despite other effective procedures, such as pars plana vitrectomy, scleral buckling surgery remains the first choice for many specialists.
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