Scleral buckling procedure explanation: a surgical method used to treat detached retina by pushing the sclera (white of the eye) back into its original position.
In the realm of ophthalmic surgery, a method known as scleral buckling is frequently used to treat a condition called retinal detachment. This procedure involves indenting the sclera, the white outer coat of the eye, with a silicone band or sponge, bringing the detached retina closer to the eye wall and facilitating its reattachment [2][5].
The process begins with a pliable silicone element being sutured to the sclera. This physical pushing of the sclera towards the detached retina counters the forces causing detachment and helps flatten the retina to the underlying tissue [2]. To further secure the retina in place, cryotherapy or laser is typically applied around the retinal break during surgery, creating scar tissue that permanently seals the retina [4][5].
Scleral buckling surgery is most commonly used for patients suffering from rhegmatogenous retinal detachments (RRD) caused by retinal tears, particularly those with uncomplicated or localized detachments without extensive proliferative vitreoretinopathy (PVR) [1][4]. This includes younger or phakic patients, as scleral buckling can preserve the lens and may induce less cataract progression compared to vitrectomy [4]. However, patients with advanced PVR, multiple or giant retinal breaks, significant vitreous hemorrhage, total retinal detachment with multiple breaks, or advanced PVR often require vitrectomy or combined procedures [4].
In complex cases, scleral buckling may be combined with pars plana vitrectomy to relieve traction and improve outcomes [1][4]. It's important to note that scleral buckling procedures are complex and there are many different ways to carry out the surgery.
After the surgery, a person's eye may feel sore, and they may need to wear an eyepatch for a day, avoid heavy lifting and exercise, and attend a follow-up visit with a doctor. The recovery time after scleral buckling surgery can vary from 2-6 weeks.
It's crucial to understand that anyone can have a detached retina, but people with certain conditions like diabetic retinopathy, myopia, degenerative myopia, posterior vitreous detachment, retinoschisis, lattice degeneration, a history of trauma, a family history of RRDs, or who have undergone cataract surgery are at higher risk. Surgeons may also use lasers or freeze treatments to repair any tears in a person's retina.
In summary, scleral buckling is a foundational surgical approach for certain types of retinal detachment, tailored according to detachment complexity and patient characteristics [1][2][4][5]. However, like any surgery, it does come with potential risks such as diplopia, refractive changes, infections, strabismus, glaucoma, anterior segment ischemia, motility disturbances, and eye muscle problems. One of the risks after scleral buckling is choroidal detachment, which occurs in between 23-44% of cases but usually settles down naturally in about 2 weeks.
The retina, a layer of light-sensitive cells at the back of the eye, helps people see. A detached retina is when the retina peels away from the supporting tissue at the back of the eye. This condition can cause blurry vision and is a medical emergency. Scleral buckling surgery is used to reattach a detached retina and close any breaks in the retina, using small devices called buckles to hold the retina in place.
References:
- American Academy of Ophthalmology. (2021). Scleral Buckling. In Retina. https://www.aao.org/eye-care/diseases/scleral-buckling-overview
- American Academy of Ophthalmology. (2021). Retinal Detachment. In Retina. https://www.aao.org/eye-care/diseases/retinal-detachment-overview
- American Academy of Ophthalmology. (2021). Rhegmatogenous Retinal Detachment. In Retina. https://www.aao.org/eye-care/diseases/rhegmatogenous-retinal-detachment-overview
- American Academy of Ophthalmology. (2021). Scleral Buckling and Combined Procedures. In Retina. https://www.aao.org/eye-care/procedures/scleral-buckling-and-combined-procedures
- American Academy of Ophthalmology. (2021). Proliferative Vitreoretinopathy. In Retina. https://www.aao.org/eye-care/diseases/proliferative-vitreoretinopathy-overview
The scleral buckling surgery is a part of science and health-and-wellness that focuses on eye-health, often used for medical-conditions like rhegmatogenous retinal detachments. This surgery, which involves the use of silicone elements and other methods, aims to reattach a detached retina and close any retinal breaks, thereby improving eye health. However, like any medical procedure, it carries potential risks such as choroidal detachment and other eye-related complications.
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