What is Scleral Buckling

Scleral buckling is a procedure to fix retinal detachment. Retinal detachment occurs when the thin membrane that covers the back of your eye (retina) separates (detaches) from your eyeball.

The retina is the part of your eye that sends visual signals to your brain along the optic nerve. Retinal detachment is an emergency, and surgery will be done as soon as possible to prevent loss of vision.

During this procedure, a silicone rubber or silicone sponge “buckle” will be placed on the outside of your eye to reattach your retina.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had. This includes eye surgeries, especially LASIK.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Scarring that may require removal of the buckle.
• Failure to reattach the retina or improve eyesight.
• Failure to prevent further or repeat detachment.
• A buildup of pressure inside the eye (glaucoma).
• Fluid buildup under the retina, which may require drainage.
• Infection.
• Swelling or scarring of the central part of the retina (macular edema or macular pucker), which may require further treatment, including possible surgery.
• Double vision from eye muscle damage or imbalance.
• Changes in eyesight from changing the shape of the eye.
• Formation of a cataract. A cataract is cloudiness on the lens of your eye.

What happens before the procedure?

• You may have an eye exam.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone stay with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your eyelashes may be clipped.
• An IV tube may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic). This may be given as eye drops.
  • A medicine to make you fall asleep (general anesthetic).
• You will get eye drops in your eye. The eye drops will dilate your pupil and let your health care provider see inside your eye.
• An instrument that holds your eye open (lid speculum) will be placed on your eye.
• An incision will be made to peel away the outer covering of your eye (conjunctiva).
• Your surgeon will use a microscope to inspect your retina. Your eye will be moved or squeezed to look for areas of retinal detachment.
• Your surgeon will use either a freezing probe or a laser to reattach your retina.
• A drainage hole may be made if fluid needs to drain from inside your eye.
• The buckle will be placed over part of or completely around your eye, depending on the areas of detachment. The buckle will be placed over any drainage hole that was made.
• The buckle will be secured in place with absorbable stitches (sutures).
• The conjunctiva will be secured over your eye with absorbable sutures.
• Antibiotic and steroid medicine will be injected below the conjunctiva.
• Antibiotic ointment will be placed in your eye, and an eye shield will be placed over your eye.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given a shield to place over your eye.
• You may be given medicine for pain.
• Do not drive for 24 hours if you received a sedative.
• You will need to attend a follow-up visit with your health care provider.

Scleral Buckling, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have a shield over your eye and:

• A scratchy sensation in your eye.
• Eye pain.

After your eye shield is removed, you may notice:

• Blurred vision.
• Redness in your eye.
• Swelling around your eye.

Follow these instructions at home:

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg). Do not lift, exercise, or do physical activity until your health care provider approves.
• You may need to lie still and avoid all activity for a few days. Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not drive for 24 hours if you received a sedative during your procedure. Ask your health care provider when it is safe for you to start driving.

Lifestyle

• Do not wear eye makeup or contact lenses until your health care provider approves.
• Wear sunglasses during the day if your eye is sensitive to light.
• Do not fly until your health care provider approves.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Take and use over-the-counter and prescription medicines only as told by your health care provider. This includes eye drops. You may need more than one type of drop. Do not stop using the eye drops even if you start to feel better.
• Keep all follow-up visits as told by your health care provider. This is important. You will need to return to your surgeon soon after surgery. Your eye shield may be removed at this visit.

Contact a health care provider if:

• You have more redness, swelling, or pain in your eye.
• You have a fever or chills.
• You have drainage or pus coming from your eye.
• Your vision gets worse.

Get help right away if:

• You have severe pain in your eye.
• You have sudden loss of vision.