Buckling is the procedure in which an indentation is produced on sclera to appose neurosensory retina to retinal pigment epithelium (RPE).
Scleral buckles come in many shapes and sizes. An encircling band is a thin silicone band sewn around the circumference of the sclera of the eye. 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. This moves the sclera closer to the detached retina. It also may move the retina closer to the vitreous. 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.
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.
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.
Following are some of the scleral buckles and accessories used during surgery:
Author: Dr. Imran Saleem
Consultant Ophthalmologist & Senior Registrar at Bahawal Victoria Hospital, Bahawalpur