Our Summary

This research paper looked at the reasons for and outcomes of removing a scleral buckle (SB), a device used in eye surgery. The study considered patients who had their SB removed between 2010 and 2016, and had at least a year of follow-up checks.

The most common reasons for removing the SB were exposure of the device (54% of cases), infection (26%), double vision (16%) and a re-detachment of the retina (4%). On average, the SB was removed around five and a half years after being placed, but the middle value of the set (median) was two and a half years.

After removal, some patients experienced complications. These included a re-detachment of the retina (12%), temporary high eye pressure (6%) and persistent double vision (4%). However, the patients’ best-corrected visual acuity (the best vision they could achieve with glasses or contact lenses) did not significantly change after the SB was removed.

The researchers concluded that SB removal is most commonly needed when the device is exposed, or when there is an infection or double vision. They found that the success rate is high for a single surgery to remove the SB and the risk of complications is relatively low.

FAQs

  1. What are the most common reasons for scleral buckle removal surgery?
  2. What are the potential complications after scleral buckle removal?
  3. Is there a change in visual acuity after scleral buckle removal?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully to reduce the risk of complications and ensure the best possible outcome. This may include keeping the eye clean and protected, taking prescribed medications as directed, attending follow-up appointments, and avoiding strenuous activities that could put strain on the eye. It is also important to report any unusual symptoms or changes in vision to the doctor promptly.

Suitable For

Patients who are typically recommended scleral buckle surgery include those with exposed scleral buckle, infection, diplopia, and recurrent retinal detachment. The timing of the surgery may vary, but it is generally recommended after a certain period following the initial placement of the scleral buckle. The success rate of the surgery is high, and the risk for complications is relatively low. It is important for patients to discuss their specific case with their ophthalmologist to determine if scleral buckle surgery is the best treatment option for them.

Timeline

Before scleral buckle surgery:

  1. Patient experiences symptoms such as blurred vision, flashes of light, or floaters, indicating a retinal detachment.
  2. Patient undergoes a comprehensive eye examination, including imaging tests such as ultrasound or optical coherence tomography, to confirm the diagnosis of retinal detachment.
  3. Surgeon recommends scleral buckle surgery as a treatment option to reattach the retina and prevent vision loss.
  4. Patient undergoes preoperative evaluations and preparations for the surgery, including discussing the risks and benefits of the procedure.

After scleral buckle surgery:

  1. Patient undergoes a period of recovery after the surgery, which may involve some discomfort, redness, and swelling in the eye.
  2. Patient is closely monitored by the surgeon for any signs of complications, such as infection or increased pressure in the eye.
  3. Patient may need to use eye drops or other medications to aid in the healing process and prevent infections.
  4. Follow-up appointments are scheduled to assess the success of the surgery and monitor the reattachment of the retina.
  5. In some cases, the scleral buckle may need to be removed due to complications such as exposure, infection, diplopia, or recurrent retinal detachment.
  6. If SB removal is necessary, the procedure is performed, and the patient is monitored for postoperative complications and changes in visual acuity.
  7. Overall, the success rate of scleral buckle surgery is high, and the risk of complications is relatively low, with no significant change in visual acuity after SB removal in most cases.

What to Ask Your Doctor

  1. What are the indications for scleral buckle removal surgery?
  2. How long after scleral buckle placement is it typically recommended to have the buckle removed?
  3. What are the potential complications of scleral buckle removal surgery?
  4. How will my vision be affected after scleral buckle removal?
  5. What is the success rate of scleral buckle removal surgery?
  6. Are there any alternative treatments to scleral buckle removal for my specific condition?
  7. How long is the recovery period after scleral buckle removal surgery?
  8. Will I need to follow any specific post-operative care instructions after the surgery?
  9. What is the likelihood of needing additional procedures after scleral buckle removal?
  10. Are there any long-term effects or risks associated with having a scleral buckle removed?

Reference

Authors: Eshraghi H, Prenner JL, Zhang R, Roth DB, Wheatley HM, Fine HF, Mantopoulos D. Journal: Ophthalmic Surg Lasers Imaging Retina. 2021 Mar;52(3):138-144. doi: 10.3928/23258160-20210302-04. Epub 2021 Mar 1. PMID: 34038688