Retinal detachments are repaired by a surgical procedure called “scleral buckle”. Most retinal detachments are caused by breaks or tears in the peripheral retina which in turn are usually caused by traction or pulling of the vitreous (gelatin that fills the eye) on the peripheral retina. In order to close or seal the retinal tear, retinal surgeons must create an indentation or buckle on the eyeball. This buckling effect closes the retinal tear and also helps to prevent further retinal breaks caused by continuous vitreous traction.
The buckling material that is most commonly used is made of silicone. This is placed on the eye and held in place with sutures and a silicone belt to prevent it from slipping. The silicone creates the desired indentation on the globe, exactly where the tears which caused retinal detachment were located. The scleral buckle normally remains in place throughout the patient’s life since silicone is a material which is well tolerated. After the eye has recovered from surgery, the patient is not aware that anything is present.
Very rarely part of the scleral buckle either starts to extrude through the eyeball or may become infected or, in some cases, may start to erode or indent the eyeball too much. In this event, the scleral buckle is either removed or loosened. Sometimes scleral buckles will cause a slight muscle imbalance due to scar tissue forming around them and patients may occasionally have double vision for a few months following surgery. This double vision is usually temporary and is well tolerated by most patients.
The success rate of retinal detachment repair is very high with modern surgery.