Scleral Buckling Surgery for Retinal Detachment

Q: Scleral Buckling Surgery for Retinal Detachment

Hello Mr. <br>Yang：<br>1. <br>The phrase "depending on the condition, laser treatment may also be performed" implies that there are cases where laser treatment is not necessary, correct? Typically, laser treatment or cryotherapy is applied around the retinal tear. <br>Additional

Scleral Buckling Surgery

Thank you, Dr.
Gao, for your response.
A silicone implant is placed on the outer layer of the sclera, applying a compressive force to the sclera, which reduces the traction between the vitreous body and the retina, while also sealing retinal tears.
This helps to evacuate the fluid beneath the retina, allowing the detached retina to reattach.
Sometimes, depending on the condition, laser reinforcement may also be performed.

*Lastly, I would like to ask Dr.
Gao:
1.
Does "depending on the condition, laser reinforcement may also be performed" mean that some patients may not require laser treatment?
2.
If laser treatment is not needed, is there still a risk of the reattached retina detaching again (assuming normal usage)?
3.
Does the silicone implant placed on the outer sclera need to be removed eventually?
4.
For patients who undergo "scleral buckle surgery," does this mean that the traction between the vitreous body and the retina is eliminated?
Thank you again for your clarification, Dr.
Gao!

Mr. Yang, 40~49 year old female. Ask Date: 2020/03/11

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Yang:
1.
The phrase "depending on the condition, laser treatment may also be performed" implies that there are cases where laser treatment is not necessary, correct? Typically, laser treatment or cryotherapy is applied around the retinal tear.
Additional intervention reduces the chances of detachment recurrence.
2.
If laser treatment is not required, is there still a risk of re-detachment for the reattached retina (assuming normal usage)? Generally, laser treatment or cryotherapy is performed to prevent re-detachment.
3.
Does the silicone implant placed on the outer sclera need to be removed eventually? Usually, it does not need to be removed unless there is displacement or other symptoms.
4.
For patients undergoing "scleral buckle surgery," the traction between the vitreous and the retina is eliminated, correct? By applying pressure externally, the sclera indents, which naturally reduces the pulling force of the vitreous.
However, each physician may have different approaches, so it is best to discuss with the attending physician.
Taiwan E-Hospital Puzi Hospital Ophthalmology:
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Wednesday: 2:00 PM – 4:30 PM
Online responses should only be used as a reference; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.

Gao Pilin

Reply Date: 2020/03/11

More Info

Scleral buckling surgery is a well-established procedure used to treat retinal detachment, a serious condition where the retina separates from the underlying supportive tissue. This surgery involves placing a silicone band (the buckle) around the sclera (the white outer layer of the eyeball) to relieve the traction exerted by the vitreous gel on the retina. The buckle helps to close any retinal tears or holes, allowing the fluid that has accumulated beneath the retina to drain away, which facilitates the reattachment of the retina.

1. Laser Treatment: The statement "depending on the condition, laser treatment may also be performed" indicates that not all patients undergoing scleral buckling will require additional laser therapy. Laser photocoagulation is often used to create scar tissue around retinal tears, which can help seal them and prevent further detachment. However, if the detachment is straightforward and the buckle effectively addresses the issue, the surgeon may determine that laser treatment is unnecessary.

2. Risk of Re-detachment: If laser treatment is not performed, the risk of re-detachment depends on various factors, including the extent of the initial detachment, the presence of additional retinal tears, and the overall health of the retina. While the scleral buckle reduces the traction on the retina, it does not eliminate the risk of re-detachment entirely. Regular follow-up appointments are crucial to monitor the retina's status and ensure that it remains attached.

3. Silicone Band Removal: The silicone band used in scleral buckling surgery typically does not need to be removed unless there are complications or specific reasons to do so. In most cases, the band remains in place permanently without causing issues. However, if the band causes discomfort or if there are other complications, the surgeon may consider its removal.

4. Traction Between Vitreous and Retina: While scleral buckling significantly reduces the traction between the vitreous gel and the retina, it does not completely eliminate it. The procedure alters the dynamics of the eye, which can help stabilize the retina. However, the vitreous gel may still exert some force on the retina, especially if it is still attached in areas where there are no tears or detachments. In some cases, additional procedures, such as vitrectomy (removal of the vitreous gel), may be necessary if there are ongoing issues with traction.

In summary, scleral buckling surgery is a critical intervention for retinal detachment, and while it effectively reduces the risk of re-detachment, ongoing monitoring and follow-up care are essential. Patients should maintain regular appointments with their ophthalmologist to assess the health of their retina and address any concerns that may arise post-surgery. If you have further questions or specific concerns about your condition or that of a loved one, it is always best to consult directly with your eye care professional for personalized advice and treatment options.

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