Our Summary

This research paper discusses a case where a non-invasive method was used to address a recurring issue of retinal detachment, a serious eye condition where the retina peels away from its underlying layer of support tissue, after a surgical procedure known as scleral buckle.

The scleral buckle surgery, although popular for treating retinal detachment, can sometimes fail. In such cases, another method called pneumatic retinopexy was used. The case presented in the paper shows that this method may be a good option to consider before resorting to a more invasive surgery known as vitrectomy, especially in cases where there is a retinal break but no other serious eye disease.

The advantage of using pneumatic retinopexy in this case was that it prevented another major surgery, and a good outcome was achieved using a less invasive procedure.

FAQs

  1. What is scleral buckle surgery and what is its purpose?
  2. Why might scleral buckle surgery fail to treat retinal detachment?
  3. What is secondary pneumatic retinopexy and how can it be used in cases of recurrent retinal detachment after scleral buckle surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including avoiding strenuous activities and wearing any prescribed eye protection. It is important to attend all follow-up appointments to monitor the healing process and address any concerns promptly. It is also important to report any changes in vision or symptoms such as pain or redness to your doctor immediately.

Suitable For

Patients who are typically recommended scleral buckle surgery are those with retinal detachment, especially those with retinal breaks without proliferative vitreoretinopathy. This surgery may be recommended as a primary treatment or as a secondary treatment in cases of recurrent retinal detachment after a previous scleral buckle surgery. In some cases, secondary pneumatic retinopexy may be considered as an alternative before opting for more invasive surgeries such as vitrectomy. Ultimately, the recommendation for scleral buckle surgery will depend on the individual patient’s specific condition and needs.

Timeline

Before scleral buckle surgery:

  1. Patient presents with symptoms such as blurred vision, flashes of light, or dark spots in vision.
  2. Ophthalmologist conducts a comprehensive eye examination, including a dilated eye exam to diagnose retinal detachment.
  3. Patient undergoes imaging tests such as ultrasound or optical coherence tomography to confirm the diagnosis.
  4. Surgical consultation is scheduled to discuss treatment options, including scleral buckle surgery.
  5. Pre-operative tests and evaluations are conducted to assess the patient’s overall health and suitability for surgery.

After scleral buckle surgery:

  1. Patient undergoes the scleral buckle surgery procedure, which involves placing a silicone band around the eye to support the retina and close retinal tears.
  2. Post-operative care includes frequent follow-up visits to monitor the healing process and ensure the retina remains attached.
  3. Patients may experience discomfort, redness, or swelling in the eye in the days following surgery.
  4. Vision may initially be blurry or distorted, but improves as the eye heals.
  5. In some cases, patients may experience complications such as recurrent retinal detachment, requiring additional treatments such as pneumatic retinopexy.
  6. Long-term follow-up is necessary to monitor for any complications or changes in vision.

What to Ask Your Doctor

  1. What is scleral buckle surgery and how does it work to treat retinal detachment?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How successful is scleral buckle surgery in treating retinal detachment?
  4. What is the recovery process like after scleral buckle surgery?
  5. Are there any alternative treatments to scleral buckle surgery for retinal detachment?
  6. How long will it take for me to fully recover from scleral buckle surgery?
  7. What are the chances of the retinal detachment recurring after scleral buckle surgery?
  8. How often will I need follow-up appointments after the surgery?
  9. Are there any restrictions or limitations on activities after scleral buckle surgery?
  10. What should I do if I experience any complications or changes in my vision after the surgery?

Reference

Authors: Balakrishnan D, Oli A. Journal: BMJ Case Rep. 2019 Aug 10;12(8):e230400. doi: 10.1136/bcr-2019-230400. PMID: 31401580