A scleral buckle is one of several

ophthalmologic Ophthalmology (, ) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a ...

procedures that can be used to repair a

retinal detachment Retinal detachment is a condition where the retina pulls away from the tissue underneath it. It may start in a small area, but without quick treatment, it can spread across the entire retina, leading to serious vision loss and possibly blindness. ...

. 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. 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 In Organosilicon chemistry, organosilicon and polymer chemistry, a silicone or polysiloxane is a polymer composed of repeating units of siloxane (, where R = Organyl group, organic group). They are typically colorless oils or elastomer, rubber ...

band sewn around the circumference of the

sclera The sclera, also known as the white of the eye or, in older literature, as the tunica albuginea oculi, is the opaque, fibrous, protective outer layer of the eye containing mainly collagen and some crucial elastic fiber. In the development of t ...

of the

eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...

. A solid silicone grooved tyre element is also used. Buckles are often placed under a band to create a dimple on the eye wall. The scleral buckle is secured around the eyeball under the

conjunctiva In the anatomy of the eye, the conjunctiva (: conjunctivae) is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with gobl ...

. 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 Physics is the scientific study of matter, its Elementary particle, fundamental constituents, its motion and behavior through space and time, and the related entities of energy and force. "Physical science is that department of knowledge whi ...

physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...

of this process are not fully understood. Retinal detachment surgery usually also involves the use of

cryotherapy Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy can be used in many ways, including whole body exposure for therapeutic health benefits or may be used locally to treat ...

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. Scleral buckles are done using local or general

anesthesia Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...

and are often done as

outpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other healt ...

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. A link between scleral buckles and

Adie syndrome Adie syndrome, also known as Holmes–Adie syndrome, is a neurological disorder characterized by a tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation (i.e., light-near dissociation). It is ...

may exist. 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.

References

External links

Scleral buckling surgery information from WebMD
* {{Eye procedures Eye surgery

See also

References

External links