Scleral Buckle Surgery

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Scleral Buckle

Scleral buckle surgery is a proven method for repairing retinal detachment, a serious eye condition that can lead to permanent vision loss if left untreated. The goal of the procedure is to bring the retina back into proper position by gently pressing the eye wall inward using a flexible band. This relieves the tension that caused the detachment and allows the retina to reattach and heal.

At Northeast Wisconsin Retina Associates, our experienced retinal surgeons perform scleral buckle procedures using the latest techniques and equipment. For many patients with specific types of retinal detachment, a scleral buckle remains one of the most effective and time-tested surgical options.

Types of Retinal Detachment Treated with Scleral Buckle

The scleral buckle procedure is most commonly used to treat:

• Rhegmatogenous retinal detachment, which is caused by a tear or break in the retina that allows fluid to accumulate underneath
• Retinal detachment associated with lattice degeneration
• Retinal detachment in younger patients or those with no previous cataract surgery
• Some complex or recurrent retinal detachments (often in combination with other procedures like vitrectomy)
• Previous failed retinal detachment surgery
• Retinal detachment with the absence of posterior vitreous detachment (PVD)
  Your retina specialist will determine whether a scleral buckle is the best approach based on the size, location, and cause of your detachment.

How the Procedure Works

Scleral buckle surgery is typically performed under local anesthesia with sedation or, in some cases, general anesthesia. Here’s how the procedure works:

• Identifying the tear: Your surgeon locates the retinal break or detachment area using an operating microscope.
• Cryotherapy or laser: The tear is sealed with cold (cryotherapy) or heat (laser) to promote scarring and reattachment.
• Placing the buckle: A soft silicone band (the “buckle”) is sewn onto the outside of the sclera (white part of the eye), creating gentle pressure that pushes the eye wall inward toward the retina.
• Draining fluid: If needed, fluid under the retina is drained to help the retina settle back into place.
• Closing the eye: The incisions are closed, and antibiotic ointment is applied.
  The buckle itself remains in place permanently and is not visible from the outside.

What to Expect During Recovery

Scleral buckle surgery is an outpatient procedure, but your recovery will take time and care. After surgery, you may experience blurry vision, eye soreness, and redness for a few days to weeks. Eye drops will be prescribed to reduce inflammation and prevent infection. You may also need to wear an eye shield while sleeping to avoid pressure on the eye. Activities like strenuous exercise, heavy lifting, or bending should be avoided for 1–2 weeks.

Your vision will gradually improve as the retina heals, although it may take several weeks or months to stabilize. In some cases, full vision may not return if the macula (central retina) was involved in the detachment.

Risks and Potential Complications

As with any eye surgery, a scleral buckle procedure carries some risks. Although complications are uncommon, they can include:

• Infection
• Bleeding
• Increased eye pressure
• Double vision or eye muscle imbalance
• Re-detachment of the retina
• Cataract formation (more common in older adults)
  Our team takes every precaution to minimize these risks and will monitor you closely during follow-up appointments.

Long-Term Effectiveness of Scleral Buckle

When performed appropriately, scleral buckle surgery has a high success rate in reattaching the retina and preserving vision. In some cases, a combined approach using scleral buckle and vitrectomy offers the best chance of success.

The buckle remains in place permanently, and most patients adjust to it without any awareness or discomfort.