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Understanding Scleral Buckling Surgery

Scleral buckling surgery is a type of eye surgery done to repair a detached retina. It can restore vision.

What is a detached retina?

The retina is a very thin layer of cells at the back of your eye. These cells detect light and send visual information to your brain. Retinal detachment happens when your retina pulls away from the inner wall of your eye. When that happens, your retina doesn't work normally. Vision is lost in all or part of your retina, depending on how much of the retina has detached. If not treated right away, this can cause permanent loss of eyesight.

Certain things make it more likely that you will have a retinal detachment. These include:

  • Nearsightedness

  • Other eye disorders, like uveitis

  • Past cataract surgery

  • Older age

  • Diabetes

  • Certain inflammatory disorders, like rheumatoid arthritis

Most of the time a detached retina happens on its own with no cause. But sometimes injury to the eye can cause it.

Why scleral buckling surgery is done

A detached retina can cause loss of eyesight. You may have new floaters in your eye. These look like little specks or cobwebs that float in your field of vision. These floaters can be so dense that they affect your eyesight. You might also have light flashes in your eye or a curtain over your field of vision. If you have these symptoms, you may need an emergency surgery to reattach the retina. This can restore eyesight.

How scleral buckling surgery is done

The surgeon will make a cut (incision) in the outer layer of your eye. They will use an ophthalmoscope to view your retina. A device will be used to seal the layers of your retina back together. In most cases, the device uses extreme cold to do this. A very small flexible band, called a scleral buckle, is placed around the outside of your eyeball. This gently presses the eye inward and helps make sure that your retina stays in place. The scleral buckle cannot be seen on the eye. It's usually left in place long term (permanently).

Three-quarter view of cross sectioned eye showing scleral buckle around outside of eyeball.

Risks of scleral buckling surgery

All surgery has some risks. The risks of this surgery include:

  • A scar on or under the retina (proliferative vitreoretinopathy)

  • Detachment of the eye layer beneath the retina

  • Bleeding (hemorrhage) in the eye

  • Pulling of the retina back into the retinal break or tear (retinal incarceration)

  • Infection

  • Nearsightedness that gets worse

  • Cataracts

  • Increased pressure in the eye

  • Double vision

  • New retinal tears

  • Return of a retinal detachment

  • Need for another surgery

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