Our Summary

This review discusses recent research on a surgical method called “scleral buckling” used to repair a specific type of retina damage known as “rhegmatogenous retinal detachment” (RRD). This technique has been less commonly used in recent years. The studies reviewed compared the results of scleral buckling versus another procedure called “pars plana vitrectomy” (PPV).

The findings suggest that scleral buckling may actually provide better results, especially in younger patients, and those with certain risk factors. Children, in particular, seem to do best with this type of surgery. Scleral buckling may also better prevent the retina from moving out of place compared to PPV. In some cases, combining the two methods - PPV with an additional buckle - may be beneficial, but more research is needed to confirm this.

In summary, scleral buckling plays a key role in repairing RRD and it’s important for eye surgeons to be well-trained in this method to provide the best possible care for their patients.

FAQs

  1. What is the purpose of scleral buckling in the repair of rhegmatogenous retinal detachment (RRD)?
  2. How do the outcomes of scleral buckling compare to pars plana vitrectomy (PPV) for RRD repair?
  3. Why is it considered crucial to continue training retina surgeons in the scleral buckling technique?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative care instructions carefully, including using prescribed eye drops and avoiding strenuous activities that could put strain on the eye. It is also important to attend all follow-up appointments to ensure proper healing and optimal outcomes.

Suitable For

Patients who are typically recommended scleral buckle surgery for rhegmatogenous retinal detachment repair include:

  • Younger patients
  • Phakic patients
  • Patients with certain risk factors that may benefit from scleral buckling
  • Children, who may have better outcomes with primary scleral buckling surgery
  • Patients who may benefit from a supplemental buckle in conjunction with pars plana vitrectomy

It is important for retina surgeons to continue training in scleral buckling techniques to ensure optimal outcomes for patients with retinal detachment.

Timeline

Before scleral buckle surgery:

  1. Patient experiences symptoms of rhegmatogenous retinal detachment, such as flashes of light, floaters, or a curtain-like shadow in their vision.
  2. Patient undergoes a comprehensive eye examination, including a dilated eye exam and imaging tests to confirm the diagnosis of retinal detachment.
  3. Ophthalmologist discusses treatment options with the patient, including scleral buckle surgery, pars plana vitrectomy, or pneumatic retinopexy.
  4. Patient may need to undergo pre-operative tests and evaluations to ensure they are a suitable candidate for surgery.

After scleral buckle surgery:

  1. Surgery is performed under general anesthesia or local anesthesia, and the scleral buckle (a silicone band or sponge) is placed around the eye to support the detached retina.
  2. Patient may experience some discomfort, redness, or swelling in the eye following surgery.
  3. Patient is typically discharged on the same day or the following day with instructions for post-operative care, including eye drops and restrictions on physical activity.
  4. Follow-up appointments are scheduled to monitor the healing process and adjust treatment as needed.
  5. Over time, the retina reattaches to the back of the eye, and vision may gradually improve. Some patients may require additional surgeries or treatments to address complications or recurrent detachment.

What to Ask Your Doctor

  1. What is the success rate of scleral buckle surgery for repairing my retinal detachment?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery time after scleral buckle surgery?
  4. Will I need to restrict my activities or lifestyle following the surgery?
  5. How will my vision be affected after the surgery and what is the expected visual outcome?
  6. Will I need any additional surgeries or treatments in the future after scleral buckle surgery?
  7. Are there any alternative treatment options to scleral buckle surgery for my retinal detachment?
  8. How experienced are you in performing scleral buckle surgery and what is your success rate with this procedure?
  9. What is the likelihood of the retinal detachment recurring after scleral buckle surgery?
  10. How should I prepare for the surgery and what can I expect during the procedure?

Reference

Authors: Wang KY, Adams OE, Yu MD, Yonekawa Y. Journal: Curr Opin Ophthalmol. 2024 Sep 1;35(5):376-381. doi: 10.1097/ICU.0000000000001065. Epub 2024 May 31. PMID: 38820007