Fluid Accumulation After Scleral Buckling Surgery in Teens

Postoperative serous detachment after scleral buckling for retinal detachment?

A 14-year-old child has just undergone scleral buckle surgery on the right eye and has gas tamponade.
The child has been lying face down for three days, and the doctor mentioned that there is fluid and advised side-lying.
What does it mean that there is fluid? Is this a normal phenomenon right after surgery? If a second surgery is needed, how long is the typical interval? I accidentally came across this website during the hospitalization and found the doctors' answers to be very specific and helpful.
Thank you.

Youxin Mama, 40~49 year old female. Ask Date: 2016/08/31

Dr. Gao Pilin reply Ophthalmology

Dear Concerned Mother,
The purpose of lying on your side is to allow the gas inside the eye to press against the retinal tear, while the fluid is likely the normal secretion from the eye.
Eventually, the gas will be absorbed and replaced by the fluid that is secreted.
If the surgery is successful, there should be no need for further surgery temporarily.

The Ophthalmology Department at Puzi Hospital in Taiwan is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
Please note that online responses are for reference only; it is essential to seek medical attention at a healthcare facility if necessary.

I hope to have the opportunity to assist you.
Sincerely,
Gao Pilin

Reply Date: 2016/08/31

More Info

After scleral buckling surgery, particularly in a young patient like your 14-year-old, it is not uncommon to experience fluid accumulation. This fluid can be a result of several factors related to the surgical procedure and the healing process.
Scleral buckling is a surgical technique used to treat retinal detachment. During the procedure, a silicone band (the buckle) is placed around the eye to indent the wall of the eye and relieve the traction on the retina. This allows the retina to reattach to the underlying tissue. The use of gas during the procedure is also common, as it helps to keep the retina in place while it heals.
The fluid accumulation you are noticing could be due to a few reasons:
1. Postoperative Inflammation: After any surgical procedure, including scleral buckling, inflammation is a normal part of the healing process. This inflammation can lead to the accumulation of fluid in the eye or surrounding tissues.

2. Gas Bubble: If a gas bubble was injected during the surgery, it can create a sensation of fluid accumulation as it expands and contracts. The gas bubble is meant to help keep the retina in place, and its behavior can sometimes mimic fluid accumulation.

3. Serous Retinal Detachment: In some cases, fluid can accumulate under the retina, leading to a condition known as serous retinal detachment. This is less common but can occur if the retina is not properly reattached or if there are complications.

4. Normal Healing Process: It is also possible that the fluid accumulation is simply part of the normal healing process. The body may produce fluid as it works to heal the surgical site.

Regarding your question about whether this is normal, it is generally expected to have some fluid accumulation after surgery, especially in the early days of recovery. However, it is crucial to monitor the situation closely. If the fluid accumulation increases, or if there are signs of infection (such as increased redness, pain, or discharge), it is essential to contact the surgeon or healthcare provider immediately.

As for the timing of any potential follow-up surgeries, it typically depends on the individual case and the surgeon's assessment. Generally, if a second surgery is necessary, surgeons may wait several weeks to a few months to allow the eye to heal adequately before proceeding. This waiting period allows for the resolution of any inflammation and ensures that the eye is in the best possible condition for another surgical intervention.

In summary, fluid accumulation after scleral buckling surgery can be a normal part of the healing process, but it is essential to keep an eye on it and communicate with your healthcare provider about any concerns. Regular follow-up appointments will help ensure that the healing process is on track and that any complications are addressed promptly.

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