Most often, a scleral buckle procedure can be done under local anesthesia and as same-day surgery (in and out of the hospital on the same day). Sometimes the surgeon elects to drain the subretinal fluid at the time of surgery.
Once the break is closed, the fluid under the retina (subretinal fluid) will usually spontaneously resolve over 1–2 days. The buckle is positioned so that it pushes in on the retinal break and effectively closes the break. The buckle is sewn onto the outer wall of the eyeball (sclera) to create an indentation or buckle effect inside the eye. The type and shape of the buckle vary depending on the location and number of retinal breaks. The buckle is usually a piece of silicone sponge or solid silicone. The procedure involves localizing the position of all the retinal breaks, treating all retinal breaks with the cryoprobe and supporting all the retinal breaks with a scleral buckle. It is still commonly used for rhegmatogenous retinal detachments, especially when there are no complicating factors. This surgical procedure has been in use for more than 40 years, and, until approximately 25 years ago, was the only procedure available. Scleral buckling pushes the “wall against the wallpaper” whereas pneumatic retinopexy and vitrectomy push the “wallpaper against the wall.” Surgery is usually performed within a day or two of diagnosis, particularly if the macula and central vision are not yet affected. There are several surgical options available for repairing a retinal detachment. Once the retina separates from the eye-wall it must be surgically pushed back into place the causative retinal breaks are then “glued” with laser photocoagulation or cryotherapy. White laser photocoagulation spots surround a retinal tear (arrow). This type usually occurs in conjunction with another disease affecting the eye that causes swelling or bleeding. The third type of detachment happens when an abnormal excess of fluid collects underneath the layers of the retina, causing it to separate from the back wall of the eye.Patients with diabetes are more likely to experience this type. The second most common type occurs when strands of vitreous or scar tissue create traction on the retina, pulling it loose.Patients who have undergone eye surgery or have experienced a serious eye injury are also at greater risk for this type of detachment. Nearsighted people are more susceptible to this type of detachment because their eyes are longer than average from front to back, causing the retina to be thinner and more fragile. The most common type occurs when there is a break in the sensory layer of the retina and fluid seeps underneath, causing the layers of the retina to separate.There are three types of retinal detachments: A macular pucker can also develop following a vitreous detachment. A sudden separation of the vitreous from the retina (posterior vitreous detachment) is often the inciting event causing a retinal break or detachment. In a small minority of persons with retinal breaks, liquid vitreous leaks beneath the retina, separating it from the eye-wall and causing a retinal detachment. What causes a retinal detachment?īreaks in the retinal tissue (retinal holes and retinal tears) are normally found in approximately 10% of people. Receiving immediate treatment increases the chance that you may regain lost vision and/or limit further loss. If you are experiencing symptoms of a detached retina, contact Eye Center of Texas right away. Untreated, retinal detachment usually causes permanent blindness. Shower of floaters that resemble spots, bugs, or spider webs.What are the common symptoms of retinal detachment? Painless: Central vision will be lost if the macula remains detached. The retina will degenerate and lose its ability to function if it remains detached. When the retina detaches, it separates from the back wall of the eye and is removed from its blood supply and source of nutrition. The retina outside the center of the macula, which makes up more than 95% of the retina, is not capable of the fine detailed vision. The remainder of the retina, the peripheral retina, is for side vision. The center of the retina is called the macula and is the only part capable of fine, detailed vision, i.e. Like the film in a camera, the retina is responsible for creating the images that one sees. The retina is the neurosensory tissue that lines the back wall of the eye. What You Should Know About Retinal Detachment