A Patient-Friendly Guide to Scleral Buckle Surgery and Retinal Repair

Scleral buckle surgery is a procedure used by retina specialists to repair retinal detachments and certain complex retinal tears. A retinal detachment occurs when the retina, the thin layer of nerve tissue lining the back of the eye, pulls away from its normal position. Because the retina is responsible for capturing light and sending visual signals to the brain, a retinal detachment can threaten permanent vision loss if not treated promptly.

A scleral buckle works by gently pushing the outer wall of the eye inward to support the detached retina and relieve pulling forces from the vitreous gel inside the eye. Many patients think of a scleral buckle as a “belt” or “support band” placed around part of the eye. The buckle itself is usually made of soft silicone material and is sewn onto the outside of the eye (the sclera, or white part of the eye). You cannot see the buckle from the outside after healing, and most patients do not feel it once recovery is complete.

During surgery, your retina specialist identifies and treats the retinal tear or detachment. Laser treatment or freezing treatment (called cryopexy) is often used to seal retinal breaks. The scleral buckle helps support these areas while the retina heals. In some patients, fluid beneath the retina may be drained during surgery. Depending on the complexity of the retinal detachment, scleral buckle surgery may be performed alone or combined with other procedures such as vitrectomy or placement of a gas bubble inside the eye.

The procedure is performed in an operating room and may be done under local anesthesia with sedation or general anesthesia. Most patients go home the same day. After surgery, the eye may feel sore, swollen, or irritated for several days. Mild redness, tearing, blurry vision, or discomfort are common during the healing period.

Vision recovery varies from patient to patient and often depends on how severe the retinal detachment was and whether the macula, the center of the retina responsible for detailed vision, was detached before surgery. Vision may improve gradually over weeks to months. Even when vision does not return completely, successful surgery can often preserve useful vision and prevent further worsening.

If a gas bubble is placed during surgery, your surgeon may recommend special head positioning and restrictions on air travel or high-altitude travel until the gas bubble disappears. Because every retinal detachment is different, recovery instructions vary between patients.

Although scleral buckle surgery is highly effective, risks and complications can occur. These may include recurrent retinal detachment, infection, bleeding, double vision, increased eye pressure, cataract progression, refractive change (often becoming more nearsighted), or the need for additional surgery. Your retina specialist will discuss the risks and benefits based on your specific eye condition.

Follow-up appointments are extremely important after retinal detachment surgery. Call your retina specialist immediately if you notice worsening pain, increasing redness, flashes, new floaters, worsening vision, or a curtain-like shadow in your vision after surgery.