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Review
. 2022 Jan 9;11(2):314.
doi: 10.3390/jcm11020314.

Scleral Buckling: A Review of Clinical Aspects and Current Concepts

Matteo Fallico  1 , Pietro Alosi  1 , Michele Reibaldi  2 , Antonio Longo  1 , Vincenza Bonfiglio  3 , Teresio Avitabile  1 , Andrea Russo  1
Affiliations
Review

Scleral Buckling: A Review of Clinical Aspects and Current Concepts

Matteo Fallico et al. J Clin Med. .

Abstract

Scleral buckling represents a valuable treatment option for rhegmatogenous retinal detachment repair. The surgery is based on two main principles: the closure of retinal breaks and the creation of a long-lasting chorioretinal adhesion. Buckles are placed onto the sclera with the purpose of sealing retinal breaks. Cryopexy is usually performed to ensure a long-lasting chorioretinal adhesion. Clinical outcomes of scleral buckling have been shown to be more favorable in phakic eyes with uncomplicated or medium complexity retinal detachment, yielding better anatomical and functional results compared with vitrectomy. Several complications have been described following scleral buckling surgery, some of which are sight-threatening. Expertise in indirect ophthalmoscopy is required to perform this type of surgery. A great experience is necessary to prevent complications and to deal with them. The use of scleral buckling surgery has declined over the years due to increasing interest in vitrectomy. Lack of confidence in indirect ophthalmoscopy and difficulties in teaching this surgery have contributed to limiting its diffusion among young ophthalmologists. The aim of this review is to provide a comprehensive guide on technical and clinical aspects of scleral buckling, focusing also on complications and their management.

Keywords: encircling band; retinal detachment; scleral buckling; surgical complications; vitreoretinal surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) a left eye inferior rhegmatogenous retinal detachment in a young phakic patient, the macula looks attached; (B) a fully reattached retina following scleral buckling with a 360 encircling band with an inferotemporal buckle.
Figure 2
Figure 2
(A) a case of supero-temporal retinal detachment with an attached fovea; (B) following SB the retina is fully reattached, but a macular subretinal hemorrhage occurred.
Figure 3
Figure 3
A left aphakic eye with an extrusion of a MIRAgel (hydrogel) buckle through the temporal conjunctiva.
See this image and copyright information in PMC

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