Scleral Buckling

Scleral Buckling is considered to be the traditional surgery for retinal detachments.

Scleral buckling is performed using local, and in some cases, general anesthesia. The first step in this procedure is treatment of the retinal tear by use of ocular cryotherapy. The surgeon places a cryoprobe on the outside of the eye, and then, using a special instrument to look into the eye, the surgeon correctly places the cryoprobe in the vicinity of the retinal tear. The freezing action of the cryoprobe causes scarring to occur. A piece of silicone sponge, plastic or rubber is then sewn onto the outside of the eye in this same area, thus causing the eye to buckle (hence the name of the surgery) inward and holding the retina against the treated area. The scarring from the cryoprobe seals the retinal tear. The silicone buckle is left permanently in place after the surgery.

There are a variety of options that surgeons may use based upon the specific condition of the retinal detachment once it is observed from within the eye. In some cases, the retinal surgeon may place a silicon band around the entire circumference of the eye. By doing so, this reduces the pulling effect that the vitreous (fluid portion of the eye) may be placing upon the retina. The surgeon may also make a small opening in the outer wall of the eye to allow fluid to drain from behind the retina, thus improving the chances of the retina reattaching successfully. In other cases, the surgeon may inject a gas bubble directly into the vitreous cavity. After the surgery has been completed, the patient will then be positioned such that the gas bubble rises to push the retinal tear against the scleral buckle to help ensure the tear remains closed and heals.