![]() ![]() Surgical planning begins with a preoperative, peripheral retinal examination with 360-degree scleral depression to find all retinal tears. The technique we describe does not require drainage of the subretinal fluid. Detachments with vitreous hemorrhage that obscure a complete view of the peripheral retina are excluded from this article. Here, we review the repair of retinal detachments in phakic younger patients without the presence of proliferative vitreoretinopathy (PVR)-i.e., there are no fixed folds in the detached retina and the retinal tears do not have any rolled edges. Therefore, a SB that covers 5 to 7 mm of peripheral retina will close most retinal tears ( Figure 1). The vast majority of retinal tears are 1 to 3 mm in size and occur at the posterior margin of the insertion of the vitreous base, 3 to 4 mm from the ora serrata. We make the argument that SB surgery should be the initial procedure performed in phakic patients under 55 years of age who present with RRD. One of us (WHR) has operated on 8,903 retinal detachments between 19, 6,216 managed with a scleral buckle alone and 2,687 with a combined pars plana vitrectomy and SB procedure. However, the use of SB surgery remains an essential procedure in RRD management. If you leave and other questions arise, please feel free to contact us anytime.The development of small-gauge vitrectomy units with high-speed cutters, wide-angle systems and perfluorocarbon liquid has revolutionized the repair of rhegmatogenous retinal detachments and has led to the misconception that scleral buckling surgery is no longer needed in the management of RRD. If you are considering surgery, please be sure you have all your questions answered by our doctors and staff. Before recommending any surgical procedure, your doctor will discuss with you in detail the reason the surgery may be of benefit, the chances of vision loss, vision preservation, and vision gain with or without surgery, the risks of surgery, and the alternatives (if any) to surgery. In some cases, surgery is performed in an attempt to prevent further vision loss and not always to improve the vision. Vision recovery after scleral buckle surgery depends largely on the size, location and duration of the retinal detachment. Occasional Tylenol is usually all that is needed for comfort during this period. Also, your eye may feel sore for a few days to a week after surgery and reading may feel slightly uncomfortable. The sutures will initially feel a little scratchy, and over 1 to 2 weeks, they will become softer and dissolve away. A patch is placed and then you are brought back to the recovery area where you will be observed for 1-2 hours prior to being released home. ![]() ![]() Antibiotics and steroids are injected over the surface of the eye to decrease inflammation and protect against infection after surgery. If a gas bubble is used, the duration of head positioning will be determined by your doctor during and after the surgery and discussed with you.Īfter your retinal problem is repaired, the surface layers of the eye will be closed with absorbable sutures that are thinner than a hair. This might require that you position your head in a specific manner after the procedure (sometimes even face down) for a determined period of time. Once the retinal detachment is repaired, it is occasionally necessary to inject a gas bubble to help the retina heal in its proper location, particularly if scleral buckle surgery is combined with vitrectomy surgery. Alternatively, you may be placed under general anesthesia for your surgery. Many patients sleep throughout the entire process. You will gradually become more aware of your surroundings as your surgery is started, but you will remain comfortably and lightly sedated throughout the procedure. You will then be deeply sedated while your doctor administers your local anesthesia around your eye. Once in the operating room, you will have an IV started, EKG leads placed, and a blood pressure cuff applied to monitor you during the procedure. From there, you will be escorted to the operating room. There, you will meet with your surgeon as well as the anesthesiologist and operating room nursing staff. Because in a Cryotherapy (freezing treatment) is typically applied to torn areas of the retina during scleral buckle surgery in order to create small scars that will help “spot weld” the retina to the wall of the eye and prevent re-detachment.įor some diagrams of scleral buckle surgery, simply click here.īefore your procedure, your eye undergoing surgery will be dilated in the preoperative staging area by the nursing staff. To view a PDF version of this information, click here.Ī scleral buckle is a solid yet flexible silicone band placed around the outside of the eye to repair a retinal detachment. Laser Photocoagulation of Neovascular Membrane.Laser for Central Serous Retinopathy (CSR).Published/Accepted Manuscripts/Lectures. ![]()
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