Our Summary

This research paper discusses the challenges of controlling eye pressure (IOP) in glaucoma patients who have undergone a certain kind of eye surgery, called a scleral buckling procedure. This surgery involves placing a band around the eye, which can increase pressure in certain veins – and this is thought to contribute to a form of glaucoma. When the usual treatments do not work, a device can be implanted to help drain fluid and reduce pressure. However, this often requires adjusting the device and dealing with scar tissue that has formed around the band. This paper presents a case where a different kind of implant, a XEN gel stent, was used successfully to reduce eye pressure without needing to interfere with the previous surgery. This could be a significant improvement over previous methods.

FAQs

  1. What is the potential impact of a scleral buckling procedure on intraocular pressure control in glaucoma patients?
  2. What is the preferred procedure if medical management fails to control intraocular pressure after a scleral buckling procedure?
  3. Can the XEN gel stent implantation successfully reduce intraocular pressure without affecting the previous scleral buckle?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scleral buckle surgery is to follow post-operative instructions carefully, including keeping the eye clean and avoiding any strenuous activities that could put pressure on the eye. It’s also important to attend follow-up appointments to monitor healing and ensure the best possible outcome. If there are any concerns or changes in vision, it’s important to contact the doctor immediately.

Suitable For

Patients who are typically recommended scleral buckle surgery are those with retinal detachments caused by a tear or hole in the retina, usually as a result of trauma or aging. Scleral buckle surgery is often recommended for patients with a rhegmatogenous retinal detachment, where the retina detaches due to a break or tear in the retina. Other types of retinal detachments, such as tractional or exudative detachments, may require different surgical techniques.

Timeline

Before scleral buckle surgery:

  • Patient may experience symptoms of retinal detachment, such as sudden onset of flashes, floaters, or loss of vision
  • Patient undergoes a comprehensive eye examination, including imaging tests like ultrasound or optical coherence tomography to confirm the diagnosis of retinal detachment
  • Surgical consultation is scheduled and the risks and benefits of scleral buckle surgery are discussed with the patient
  • Pre-operative tests are conducted to assess the patient’s general health and suitability for surgery
  • Patient may be advised to stop taking certain medications or to fast before the surgery

After scleral buckle surgery:

  • Patient is monitored closely in the immediate post-operative period for any signs of complications such as infection or increased intraocular pressure
  • Patient may experience discomfort, redness, or swelling in the eye for the first few days after surgery
  • Follow-up appointments are scheduled to check the healing process, adjust any medications, and monitor the success of the surgery in reattaching the retina
  • Patient may need to avoid strenuous activities, heavy lifting, or bending over for a period of time to prevent complications
  • Vision may gradually improve over several weeks to months as the eye heals, but some patients may experience permanent changes in vision or require additional treatments for complications such as cataracts or glaucoma.

What to Ask Your Doctor

  1. What is the purpose of scleral buckle surgery?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery period after scleral buckle surgery?
  4. Will I need to take any medications after the surgery?
  5. How will the surgery affect my vision in the long term?
  6. Are there any lifestyle changes I should make after the surgery?
  7. What follow-up appointments will be necessary after the surgery?
  8. Can scleral buckle surgery affect my intraocular pressure and increase the risk of glaucoma?
  9. Are there any alternative treatment options to scleral buckle surgery?
  10. Will I need any additional procedures in the future related to the scleral buckle surgery?

Reference

Authors: Vu DM, Junk AK. Journal: Ophthalmic Surg Lasers Imaging Retina. 2020 May 1;51(5):289-292. doi: 10.3928/23258160-20200501-07. PMID: 32511733