Post-Scleral Buckle Removal: Questions and Concerns for Patients

Inquiry about removal after scleral buckle surgery?

Dear Director Wang,
Hello! I apologize for bothering you.
In October 2007, I underwent two retinal reattachment surgeries on my left eye due to retinal detachment caused by high myopia (the procedure was called scleral buckle surgery; after the first surgery, the retina detached again two weeks later, requiring a second surgery).
One month later, I received outpatient laser treatment to stabilize the retina, which is currently stable and healthy.
With glasses, my vision can be restored to approximately 0.8.
During my most recent follow-up, the doctor mentioned that there is exposure of the scleral buckle and recommended its removal to prevent infection.
I would like to ask Director Wang the following questions:
1.
Why is the scleral buckle exposed? Is it due to excessive physical activity or occasional pressure?
2.
Clinically, are there cases where the scleral buckle has been removed after achieving retinal stability?
3.
Will the removal of the scleral buckle affect the stability of the retina?
4.
In your opinion, do you also recommend the removal of the scleral buckle?
Additionally, I have recently felt tightness in the muscles around my temple in my right eye.
Could this be related to the retina?
I am quite anxious about these issues and would greatly appreciate your assistance in clarifying them.
Thank you!

Xiao Lai, 30~39 year old female. Ask Date: 2009/06/06

Dr. Wang Zhangji reply Ophthalmology

The scleral buckle is ultimately a foreign body to the human body, which can lead to some degree of rejection, especially in patients with diabetes or those who have experienced retinal detachment due to trauma, resulting in a higher removal rate.
The rate of scleral buckle removal abroad is approximately 1%.
Removing the buckle may increase the risk of retinal detachment, but not removing it raises the risk of infection.
I would recommend that you consider scleral buckle removal.
The tightness in the temple area may be related to ciliary muscle fatigue and is not associated with the retina.
Wishing you good health.

Reply Date: 2009/06/06

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the scleral buckle removal and the condition of your eyes. I understand that you have undergone significant procedures in the past due to retinal detachment, and it is completely natural to have questions about your current situation. Let’s address your concerns one by one.

1. Why does the scleral buckle become exposed?
The exposure of the scleral buckle can occur for several reasons. It may be related to the healing process of the eye, where the surrounding tissues do not adequately cover the buckle. Activities that involve significant eye movement or pressure, such as heavy lifting or vigorous exercise, can contribute to this issue. Additionally, factors like inflammation or changes in the eye's shape can also lead to exposure. It is essential to follow your doctor's recommendations regarding activity levels post-surgery to minimize such risks.

2. Are there clinical cases where the scleral buckle was removed after retinal stability?
Yes, there are documented cases where patients have had their scleral buckles removed after achieving retinal stability. The decision to remove the buckle typically depends on the individual’s specific circumstances, including the stability of the retina, the presence of any complications, and the overall health of the eye. Your ophthalmologist will consider these factors when making a recommendation.

3. Will the removal of the scleral buckle affect retinal stability?
In most cases, if the retina has stabilized and there are no signs of detachment or other complications, the removal of the scleral buckle should not adversely affect retinal stability. However, every patient is unique, and the potential risks and benefits should be thoroughly discussed with your ophthalmologist. They will monitor your condition closely before and after the procedure to ensure that your retina remains stable.

4. Should I proceed with the removal of the scleral buckle?
Based on your description of the buckle's exposure and the potential risk of infection, it is generally advisable to consider its removal, especially if your retina is stable. However, this decision should be made in consultation with your ophthalmologist, who can assess your specific situation and provide personalized advice.

Regarding the tightness you feel in the muscles around your temple, this is unlikely to be directly related to your retinal condition. Muscle tension in that area can arise from various factors, including stress, eye strain, or even posture. If this discomfort persists, it may be worth discussing with your healthcare provider to rule out any underlying issues.

In summary, I encourage you to have an open discussion with your ophthalmologist about your concerns and the best course of action regarding the scleral buckle. It is essential to address any anxiety you may have about your eye health, and your doctor can provide the reassurance and guidance you need.

Thank you for your inquiry, and I wish you the best in your recovery and ongoing eye health.

Sincerely,
Doctor Q&A Teams

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