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Scleral buckling | Retinal detachment

Scleral buckling , also called a scleral buckle or encircling band, is an “external” surgical technique used to treat certain retinal detachments. The principle is easy to understand: a small silicone device is placed on the wall of the eye, the sclera, to bring it closer to the retina at the site of the tear. This reduces traction, promotes reattachment, and helps the retina heal in the correct position.

Important to know: scleral buckling mainly treats the “tear + traction” mechanism. The ultimate aim remains the same: achieve lasting retinal reattachment and preserve useful vision.
Purpose Reattach the retina from outside the eye
Principle Silicone implant that indents the sclera
Key point Treatment of the tear + follow-up

Why choose scleral buckling?

In some detachments, the retinal tear or tears are peripheral and clearly identified. Rather than entering the eye, scleral buckling can relieve the fragile area from the outside. It may be particularly appropriate when the aim is to correct localized traction and stabilize the retina without removing the vitreous, depending on the surgeon’s assessment.

  • Localized peripheral tear or tears: A specific area requiring support.
  • Typical rhegmatogenous detachment: Caused by a tear through which fluid passes.
  • An external option: An approach from outside the eye, selected in some cases according to the patient’s profile and anatomy.
  • Decision made case by case: According to the extent of the detachment, macular involvement, traction, medical history, and other factors.

How the operation is performed

The operation is performed in the operating room under suitable anesthesia. The surgeon precisely locates the tear and then places a silicone band or small implant on the sclera at the strategic location. This indentation brings the wall of the eye closer to the retina and reduces traction.

The tear is treated, using cryotherapy and/or laser according to the surgical strategy, to reinforce the area.

Scleral buckling in Sousse, Tunisia

Key steps

  • Locating the tears: Precise examination under the microscope.
  • Placement of the buckle: A silicone band or implant is placed on the sclera.
  • Treatment of the tear: The fragile area is reinforced and sealed.
  • Final check: Stability, pressure, and postoperative assessment.

What the procedure aims to achieve

  • Closer contact: The eye wall supports the detached area.
  • Less traction: Mechanical stress on the tear is reduced.
  • Reattachment: The retina comes back into contact with its support and heals.
  • Long-term stability: Help prevent recurrence and new tears.
Can the implant be seen or cause discomfort?

The implant is placed beneath the surface tissues and is not visible from outside in most cases. Initially, some discomfort or a pulling sensation may occur, but this usually decreases as healing progresses.

Postoperative recovery: what should you expect?

During the first few days, the eye may be red and sensitive, with varying degrees of discomfort. Eye drops help reduce inflammation and protect the eye. Vision improves gradually and depends particularly on whether the macula was involved and how long the retina had been detached before surgery.

  • Redness / discomfort: Often temporary, especially at first.
  • Regular check-ups: To confirm reattachment and monitor pressure.
  • Gradual return to activities: According to instructions, avoiding physical effort and rubbing the eye.
  • Seek emergency care if you experience: a new shadow or curtain, significant pain, or sudden loss of vision.
Follow-up is not only used to “check” the result. It allows rapid action if a new tear appears or the retina shows any sign of weakness.

Frequently asked questions

Why choose scleral buckling rather than vitrectomy?

Both techniques can be highly effective. The choice depends on the configuration of the detachment, the location of the tears, vitreous traction, and the characteristics of the eye. In some cases, an external approach is sufficient; in others, vitrectomy is more appropriate.

Should the other eye be monitored?

Depending on your risk factors, such as myopia, peripheral retinal lesions, or previous history, follow-up of the other eye may be recommended. Your ophthalmologist will advise you on the appropriate frequency.