Post-Scleral Buckling Surgery: Retinal Issues and Concerns

Q: Post-Scleral Buckling Surgery: Retinal Issues and Concerns

Hello, Miss Lin： 1. If the buckle loosens, will it continue to fall down? Answer： It is possible, but it depends on the actual situation. 2. Are there cases where a loose buckle displaces but still does not require any intervention? Answer： If there is displ

Post-scleral surgery retinal issues?

Hello Doctor, I underwent scleral buckle surgery for retinal detachment in early April.
Although the tear was quite large, the doctor mentioned that after cryopexy, it had already formed a scar, and laser treatment was also performed for reinforcement.
However, the position of the buckle has shifted downward and is now more prominent, causing pain when I move my eyes.
The doctor said that my buckle has loosened.
When I asked if it needs to be surgically removed, he did not give a clear response, only stating that the pain would not be constant, that if it is loose it can be removed, and that it should be taken out if it is uncomfortable.
I would like to ask the doctor: 1.
If the buckle is loose, will it continue to move downward? 2.
Are there cases where a loose buckle has shifted but did not require any intervention? 3.
Is it "usual" to need to place a new buckle after removing the old one? 4.
Is the recovery time and complexity of the surgery to remove the buckle the same as the initial surgery to place it? Thank you, Doctor, for taking the time to answer my questions.

Lin, 20~29 year old female. Ask Date: 2019/06/30

Dr. Gao Pilin reply Ophthalmology

Hello, Miss Lin:
1.
If the buckle loosens, will it continue to fall down?
Answer: It is possible, but it depends on the actual situation.
2.
Are there cases where a loose buckle displaces but still does not require any intervention?
Answer: If there is displacement with protrusion or discomfort, it is still recommended to remove it.
3.
Is it "usually" necessary to insert a new buckle after removing the old one?
Answer: If the retina is already well adhered, it should not be necessary.
4.
Is the recovery time and complexity of the surgery to remove the buckle the same as the initial surgery to place it?
Answer: The removal is generally simpler and has a quicker recovery.
This response is for reference only; for detailed information, it is best to consult the operating surgeon.
Taiwan E-Hospital Puzi Hospital Ophthalmology:
Monday, Tuesday, Thursday, Friday: 8:00 AM - 12:00 PM
Wednesday: 2:00 PM - 4:30 PM
Gao Pilin

Reply Date: 2019/06/30

More Info

Hello, and thank you for your questions regarding your post-scleral buckling surgery. It’s understandable to have concerns after such a significant procedure, especially when experiencing discomfort or changes in your eye. Let’s address your questions one by one, and I’ll provide some additional context to help you understand the situation better.

1. If the buckle has loosened, will it continue to move down?
Yes, if the scleral buckle has loosened, it may shift further down over time. However, the extent of this movement can vary. In some cases, the buckle may stabilize in its new position without causing further issues. It’s essential to monitor your symptoms closely and communicate any changes to your ophthalmologist.

2. Are there cases where a loosened buckle does not require intervention?
There are indeed cases where a loosened buckle does not necessitate surgical intervention. If the buckle is not causing significant discomfort or affecting your vision, your doctor may choose to adopt a watchful waiting approach. However, if you experience increasing pain or other complications, further evaluation and potential intervention may be warranted.

3. Is it typical to replace the buckle if it is removed?
When a scleral buckle is removed, it is not always necessary to replace it with a new one. The decision to reapply a buckle depends on several factors, including the condition of the retina, the reason for the removal, and the overall health of your eye. Your surgeon will assess whether a new buckle is needed based on your specific situation.

4. What is the recovery time and complexity of removing the buckle compared to the initial surgery?
The recovery time and complexity of removing a scleral buckle can vary. Generally, the procedure to remove a buckle is less complex than the initial placement, as the surrounding tissues may have healed. However, it still requires careful consideration and planning. Recovery time can also differ based on individual healing responses and any additional procedures that may be necessary.

Additional Considerations
After scleral buckling surgery, it’s not uncommon to experience discomfort or pain, especially if the buckle is not positioned correctly. Pain can arise from pressure on the eye or surrounding tissues. If your discomfort persists or worsens, it’s crucial to follow up with your ophthalmologist for a thorough examination. They may perform imaging studies to assess the position of the buckle and determine the best course of action.

It’s also important to be aware of potential complications following scleral buckling, such as retinal detachment, infection, or changes in vision. Regular follow-up appointments are essential for monitoring your eye health and ensuring that any issues are addressed promptly.

In conclusion, while your concerns are valid, many patients experience varying degrees of discomfort after scleral buckling surgery. Open communication with your ophthalmologist is key to managing your symptoms and making informed decisions about your care. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from another eye specialist. Your vision and comfort are paramount, and you deserve clear answers and a treatment plan that aligns with your needs. Thank you for reaching out, and I wish you the best in your recovery.

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