O OftalmopediaAn open ophthalmology reference ⌕

Scleral buckle

AI overview

A scleral buckle is one of several ophthalmologic procedures that can be used to repair a retinal detachment.

Key points
  • It can be used to close the retinal break for both acute and chronic retinal detachments.
    source quote
    a scleral buckle can be used to close the retinal break, both for acute and chronic retinal detachments.
  • The buckle is secured around the eyeball under the conjunctiva to move the wall of the eye closer to the detached retina.
    source quote
    The scleral buckle is secured around the eyeball under the conjunctiva . This moves the wall of the eye closer to the detached retina.
  • The usage of scleral buckle is a source of debate for complex retinal detachment surgery.
    source quote
    The usage of scleral buckle is a source of debate only for complex retinal detachment surgery amongst surgeons
Treatment
  • Scleral buckles are done using local or general anesthesia and are often done as outpatient procedures.
    source quote
    Scleral buckles are done using local or general anesthesia and are often done as outpatient procedures.
  • Surgery usually involves cryotherapy or laser photocoagulation to form a permanent adhesion around the retinal break.
    source quote
    Retinal detachment surgery usually also involves the use of cryotherapy or laser photocoagulation . The laser or cryotherapy forms a permanent adhesion around the retinal break and prevents further accumulation of fluid and re-detachment.
  • The buckle is usually left in place permanently but can be removed after the retina heals or if infected.
    source quote
    In the majority of treatments the buckle is left in place permanently, although in some instances the buckles can be removed after the retina heals. The buckle may also be removed in the event of infection.
  • Buckles come in many shapes and sizes, including silicone sponges, encircling bands, and solid silicone grooved tyres.
    source quote
    Scleral buckles come in many shapes and sizes. A silicone sponge (with air filled cells) is a cylindrical element that comes in various sizes. An encircling band is a thin silicone band sewn around the circumference of the sclera of the eye . A solid silicone grooved tyre element is also used.
Red flags
  • Infection may occur, requiring removal of the buckle.
    source quote
    The buckle may also be removed in the event of infection.
  • A link between scleral buckles and Adie syndrome may exist.
    source quote
    A link between scleral buckles and Adie syndrome may exist.
Prognosis

Some evidence suggests that scleral buckle was less likely to result in a recurrence of retinal detachment than pneumatic retinopexy but that overall evidence is of low quality and insufficient.

AI-synthesized from the Wikipedia article “Scleral buckle”. Not medical advice. Verify source →
Scleral buckle
MeSH

A scleral buckle is one of several ophthalmologic procedures that can be used to repair a retinal detachment. Retinal detachments are usually caused by retinal tears, and a scleral buckle can be used to close the retinal break, both for acute and chronic retinal detachments.[citation needed]

Scleral buckles come in many shapes and sizes. A silicone sponge (with air filled cells) is a cylindrical element that comes in various sizes. An encircling band is a thin silicone band sewn around the circumference of the sclera of the eye. A solid silicone grooved tyre element is also used. Buckles are often placed under a band to create a dimple on the eye wall.[citation needed]

The scleral buckle is secured around the eyeball under the conjunctiva. This moves the wall of the eye closer to the detached retina. This alteration in the relationships of the tissues seems to allow the fluid which has formed under the retina to be pumped out, and the retina to re-attach. The physics or physiology of this process are not fully understood.[citation needed]

Retinal detachment surgery usually also involves the use of cryotherapy or laser photocoagulation. The laser or cryotherapy forms a permanent adhesion around the retinal break and prevents further accumulation of fluid and re-detachment. The usage of scleral buckle is a source of debate only for complex retinal detachment surgery amongst surgeons, and research has been conducted to compare safety and effectiveness outcomes of scleral buckling, pars plana vitrectomy with scleral buckle versus pars plana victrectomy without scleral buckle.[1]

Scleral buckles are done using local or general anesthesia and are often done as outpatient procedures. In the majority of treatments the buckle is left in place permanently, although in some instances the buckles can be removed after the retina heals. The buckle may also be removed in the event of infection.[citation needed]

A link between scleral buckles and Adie syndrome may exist.[2]Results from three randomized controlled trials of 274 patients comparing retinal detachment outcomes from pneumatic retinopexy versus scleral buckle found some evidence suggesting that scleral buckle was less likely to result in a recurrence of retinal detachment than pneumatic retinopexy but that overall evidence is of low quality and insufficient.[3]

  1. ↑ Gutierrez M, Rodriguez JL, Zamora-de La Cruz D, Flores Pimentel MA, Jimenez-Corona A, Novak LC, Cano Hidalgo R, Graue F (2017). "Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear". Cochrane Database Syst Rev. 2019 (12) CD012646. doi:10.1002/14651858.CD012646.pub2. PMC 6913240. PMID 31840810.
  2. ↑ Ebrahim, B; Frohman, L; Zarbin, M; Bhagat, N (2009). "Tonic Pupil Following Pars Plana Vitrectomy and Endolaser". Case Reports in Medicine. 2009 970502. doi:10.1155/2009/970502. PMC 2728613. PMID 19721706.
  3. ↑ Sena, Dayse F.; Kilian, Raphael; Liu, Su-Hsun; Rizzo, Stanislao; Virgili, Gianni (2021-11-11). "Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments". The Cochrane Database of Systematic Reviews. 2021 (11) CD008350. doi:10.1002/14651858.CD008350.pub3. ISSN 1469-493X. PMC 8585516. PMID 34762741.