Our Summary

This study looks at why eye surgeons might need to remove a scleral buckle, a device used to treat a detached retina, and what the risks are of the retina detaching again after this removal. The study reviewed medical records of patients who had a scleral buckle removed.

The main reasons for removing the buckle were exposure without infection, exposure with infection, high eye pressure, eye muscle issues causing misalignment or double vision, and the buckle moving to the wrong place.

After removal, about 10% of patients experienced a recurrence of retinal detachment. However, all of these patients had successful surgery to reattach the retina. Interestingly, the study found that patients who had a specific type of removal called ’encircling removal’ were more likely to have a retinal detachment again compared to those who had a ‘segmental buckle removal’.

The study concludes that removing a scleral buckle can lead to a recurrence of retinal detachment. Therefore, both the benefits and risks of removing the buckle should be considered carefully. Furthermore, close monitoring after the removal is crucial, especially for those patients whose buckle was removed through the ’encircling’ method.

FAQs

  1. Why might an eye surgeon need to remove a scleral buckle?
  2. What are the risks of retinal detachment after scleral buckle removal?
  3. Does the method of scleral buckle removal affect the likelihood of retinal detachment recurrence?

Doctor’s Tip

A doctor may advise a patient undergoing scleral buckle surgery to carefully consider the benefits and risks of removing the buckle, as there is a possibility of retinal detachment recurrence after removal. Close monitoring after the removal is crucial, especially for those who had an ’encircling’ removal method.

Suitable For

Patients who are typically recommended for scleral buckle surgery are those with a detached retina, particularly those with a primary rhegmatogenous retinal detachment. This type of detachment occurs when a tear or hole in the retina allows fluid to collect underneath, causing the retina to detach from the back of the eye. Scleral buckle surgery is often recommended for patients with this type of detachment, as it helps to close the tear or hole in the retina and reattach it to the back of the eye.

Additionally, patients who have had a previous retinal detachment or have risk factors for retinal detachment, such as extreme nearsightedness or a family history of retinal detachment, may also be recommended for scleral buckle surgery as a preventive measure.

Overall, patients who are recommended for scleral buckle surgery are those who have a detached retina or are at high risk for retinal detachment, and for whom the benefits of the surgery outweigh the risks.

Timeline

Before scleral buckle surgery, a patient may experience symptoms of a detached retina such as flashes of light, floaters, or a curtain-like shadow over their vision. They would undergo a thorough eye examination and imaging tests to confirm the diagnosis.

During the surgery, the patient would be under local or general anesthesia, and the surgeon would place a silicone band (scleral buckle) around the eye to push the retina back into place and hold it there while scar tissue forms to secure it in place. The surgery typically takes 1-2 hours.

After the surgery, the patient may experience some discomfort, redness, or swelling in the eye. They would need to follow post-operative instructions such as using eye drops, avoiding strenuous activities, and attending follow-up appointments to monitor the healing process.

In the long term, the patient may need to have the scleral buckle removed if complications arise, such as infection, high eye pressure, or misalignment issues. The risks of retinal detachment recurrence after buckle removal should be carefully considered, and close monitoring is essential to detect any signs of detachment early and prevent vision loss.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scleral buckle surgery include:

  1. What are the reasons that may necessitate the removal of a scleral buckle?
  2. What are the risks associated with removing a scleral buckle?
  3. What are the chances of experiencing a recurrence of retinal detachment after the removal of a scleral buckle?
  4. What are the different methods of removing a scleral buckle, and how do they impact the likelihood of retinal detachment recurrence?
  5. How will my eye be monitored after the removal of the scleral buckle to detect any signs of retinal detachment?
  6. What are the potential complications or side effects of the surgery to remove the scleral buckle?
  7. How long is the recovery process after the removal of the scleral buckle?
  8. Are there any specific lifestyle changes or precautions I should take after the removal of the scleral buckle to prevent retinal detachment recurrence?
  9. What is the success rate of reattaching the retina in case of a recurrence of retinal detachment after the removal of the scleral buckle?
  10. Are there any alternative treatments or options to consider instead of removing the scleral buckle?

Reference

Authors: Kim KW, Park UC, Yu HG. Journal: Korean J Ophthalmol. 2020 Dec;34(6):454-461. doi: 10.3341/kjo.2020.0099. Epub 2020 Dec 3. PMID: 33307605