Can Scleral Buckle Be Removed? Your Eye Health Concerns

Is it true that the scleral buckle cannot be removed?

At the end of last year, a dark spot appeared in the upper left quadrant of my right eye's visual field.
I went to National Taiwan University Hospital, where the doctor diagnosed me with retinal detachment and immediately arranged for hospitalization to place a scleral buckle.
After the surgery, everything went well, and the dark area disappeared.
However, about two months later, I started experiencing issues.
The time I could use my right eye decreased significantly, and every evening, I began to feel a foreign body sensation, followed by tearing.
I often found myself wiping tears and mucus while riding my bike or driving, repeating this several times each night.

Finally, I had a follow-up appointment and explained my symptoms to the doctor.
After a thorough examination, the doctor indicated that the scleral buckle was in good condition and that my right eye had inflammation, which would improve with medication.
However, my condition did not improve.
I made another appointment, and the doctor conducted further examinations, discovering that there was a filament stuck to the buckle.
After removing it, my condition was expected to improve, but it remained unchanged.
During my last follow-up, the doctor finally said that since my symptoms were affecting my daily life, we should schedule a date to remove the scleral buckle (I was overjoyed at that moment).
However, I was informed that another doctor would perform the procedure since I was not available, and it was scheduled for August 18th as an outpatient surgery, after which I could go home.

Today, on August 18th, the doctor said they would not remove the buckle because it was in good condition, and my discomfort was due to a filament stuck to the buckle.
Once it was cleared, I would no longer feel uncomfortable (I was taken aback).
Every evening, my left eye does not tear, but my right eye does, which is very distressing and unbearable.
What should I do?

Liu Minghui, 50~59 year old female. Ask Date: 2020/08/19

Dr. Cai Wenyuan reply Ophthalmology

It is not necessarily related to the scleral buckle.

Reply Date: 2020/08/19

More Info

Scleral buckle surgery is a common procedure used to treat retinal detachment, and it involves placing a silicone band around the eye to support the retina and prevent further detachment. Your experience with the scleral buckle and the subsequent discomfort you are facing raises important questions about the management of post-operative symptoms and the potential for removal of the buckle itself.

Firstly, it is essential to understand that while scleral buckles are generally intended to remain in place permanently, there are circumstances under which they can be removed. The decision to remove a scleral buckle typically depends on the patient's symptoms, the condition of the eye, and the overall success of the initial surgery. In your case, the discomfort you are experiencing, particularly the sensation of a foreign body and excessive tearing, is understandably distressing. However, your doctor has indicated that the buckle itself is functioning well, which suggests that it is effectively supporting the retina.

The inflammation you mentioned could be a result of several factors, including irritation from the buckle, dry eye syndrome, or even an allergic reaction to medications or materials used during the surgery. It is crucial to communicate openly with your ophthalmologist about the severity of your symptoms and how they impact your daily life. If the discomfort is significantly affecting your quality of life, it may warrant further investigation or even a second opinion from another specialist.

In terms of managing your symptoms, here are some recommendations:
1. Artificial Tears: If you are experiencing dryness or a sensation of a foreign body, using preservative-free artificial tears can help lubricate your eyes and alleviate discomfort.

2. Follow-Up Appointments: Continue to attend follow-up appointments with your ophthalmologist. If your symptoms persist, insist on a thorough examination to rule out any other underlying issues, such as inflammation or infection.

3. Discuss Removal Options: If your symptoms do not improve with conservative measures, discuss the possibility of removing the buckle with your doctor. Be clear about how the discomfort affects your daily activities and express your desire for a solution.

4. Lifestyle Adjustments: Consider reducing activities that may exacerbate your symptoms, such as prolonged screen time or exposure to wind and dust, which can worsen dryness and irritation.

5. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur and their severity. This information can be invaluable for your doctor in determining the best course of action.

6. Seek a Second Opinion: If you feel that your concerns are not being adequately addressed, seeking a second opinion from another ophthalmologist can provide you with additional insights and options.

In conclusion, while scleral buckles are typically not removed unless necessary, your ongoing discomfort is valid and should be thoroughly investigated. Open communication with your healthcare provider is key to finding a resolution. Remember, your comfort and quality of life are paramount, and you deserve a treatment plan that addresses your concerns effectively.

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