Everything about Scleral Buckle surgery in simple terms

Do you suddenly see small black objects, like spider webs , floating in front of your eyes? Or do you suddenly see flashes of light? Maybe you feel like a black curtain has fallen in front of your eyes? These are not symptoms that you should simply ignore. This could be a sign of retinal detachment . This is a condition that requires emergency medical treatment . If left untreated, you can lose your vision completely. Today we are talking about a very successful procedure called 'Scleral Buckle', which treats this dangerous condition.

Simply put, what is Scleral Buckle surgery?

To understand this, let's first understand a little about how our eyes work. Imagine that our eyes are like a small ball. On the inner wall of this ball is a very important, light-sensitive membrane called the retina . It's like wallpaper on a wall. The image of the things we see is formed on this retina. Then, by sending that information to the brain, we get vision .

Retinal detachment is when the retina separates from the tissues inside the eye, like wallpaper peeling off a wall. When this happens, that part doesn't get enough blood supply , so it loses its function.

Now let's look at the surgery. In scleral buckle surgery, a small silicone band or sponge (this is called a buckle) is placed around the white part of the eye, the sclera, and clamped. When the eye is pushed inward a little with this buckle, the detached retina goes back into the eye and sticks to the wall inside the eye. It's like sticking the detached wallpaper back to the wall. In this way, the retina begins to recover.

In what cases is this surgery recommended?

Your eye surgeon will usually recommend this surgery if you have a type of retinal detachment called rhegmatogenous retinal detachment . This is the most common type of retinal detachment. It occurs when a small hole or tear develops in the retina, allowing the fluid inside the eye (vitreous humor) to leak out from under the retina and pull it off.

There are several risk factors that affect this condition:

• Aging : As we age, the jelly-like substance inside the eye (vitreous) shrinks and turns into a liquid, which can cause the retina to become detached.
• Injuries to the eye: Such as a hard blow.
• Previous eye surgeries: For example, cataract surgery.
• High Myopia: Because the eye takes on an elongated shape, the retina becomes thin and easily torn.

Additionally, if you have previously had a retinal detachment treated and the condition recurs, your doctor may recommend scleral buckle surgery.

Why choose Scleral Buckle over Vitrectomy?

Vitrectomy is another major surgery currently performed to remove a detached retina. Over time, vitrectomy has become more popular than scleral buckle surgery. This may be because the recovery period after scleral buckle surgery can be a bit more complicated.

Your doctor will consider factors such as:

• The condition of the vitreous inside your eye.
• Do you have your own natural lens, or did you have cataract surgery and a lens implant?
• Whether or not you will be able to hold your head in a certain position after surgery.

How should I prepare before surgery?

Okay, now let's say the doctor has decided that you want to have this surgery. The doctor will give you clear instructions on how you should prepare beforehand.

• Medical history: Talk to your doctor about your complete medical history and current symptoms.
• Medications: Be sure to tell your doctor about all medications you take (including vitamins, supplements, and painkillers). Some medications, especially blood thinners, may need to be stopped a few days before surgery.
• Food and Drink: Your doctor will inform you about the time you should stop eating and drinking the night before surgery.
• Driver: This surgery is usually done as an outpatient procedure, so you will need to bring someone responsible to drive you home after the surgery.

What happens during the surgery?

It will be a relief for you to have some idea of ​​what will happen during the surgery.

1. Anesthesia: You will first be given a small amount of medicine through a vein to help you relax. Then, you will be given one of three types of anesthesia: local anesthesia, regional anesthesia , or general anesthesia . It is very important that you remain completely still during the surgery.

2. Eye preparation: The doctor will put eye drops that will enlarge the pupil of your eye so that he can see inside your eye better. Then, your eye will be opened with a device called a speculum .

3. Surgery: The doctor makes a small incision in the conjunctiva , the transparent membrane that covers the white of the eye (sclera). Then, once the sclera is exposed, the buckle, which is a silicone band or sponge, is placed around the eye and secured. Sometimes this can be a complete band, or it can be pieces of sponge on either side of the retina where it has detached.

4. Additional treatments: To ensure that the retina remains firmly attached, your doctor may perform laser or freezing treatment. This creates a small scar around the retinal tear, preventing it from detaching again.

5. Fluid removal: Sometimes it is necessary to remove fluid that has accumulated under the retina.

Usually, this entire surgery takes about an hour or an hour and a half.

What to expect after surgery?

After the surgery is successfully completed, your recovery period begins.

• You will be given antibiotics to prevent infection.
• You will be given an eye patch to wear that day and possibly the next day.
• You will stay in the operating room until you fully wake up from the anesthesia, and then you can go home with the person who came to take you home.
• The doctor tells me to come in for a follow-up appointment the very next day.
• You will need to limit your activities for a few days. Avoid heavy lifting or bending.
• If you experience eye pain, you can take painkillers recommended by your doctor.

What are the benefits and success rates of this surgery?

The biggest and only benefit of this surgery is that it eliminates the risk of losing your eyesight. Retinal detachment is a serious condition that can lead to permanent vision loss if left untreated. Therefore, it is very important to get treatment as soon as possible.

What are the risks of surgery?

As with any surgery, there are risks and complications that can occur. These are rare, but it's important to be aware.

How long does it take to heal?

Now you're asking, "Okay, when can I start working normally again?" It can take two to four weeks or a little longer to fully recover. It can also take several months for your vision to stabilize.

Ask your doctor exactly when you can resume the following activities:

• Bathing, taking a shower.
• Starting work or school.
• Starting to drive.
• Doing strenuous work like lifting weights or playing sports.
• Going swimming.

When do you suddenly need to call the doctor?

When you go home after surgery, it is very important to seek medical advice immediately if you develop any of the following symptoms: If you experience any of the following symptoms, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

• If the eye pain becomes severe.
• If the eye swelling increases.
• If your eyesight gets worse.

If you experience these symptoms, don't delay. It could be a sign of an infection or other serious complication.