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                                            Safety Information Article
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       Scleral Buckle (Scleral Buckling Procedure) 

The application of a scleral buckle (note, this is a procedure not an implant) or "scleral buckling" is a surgical technique used to repair retinal detachments and was first used experimentally by ophthalmic surgeons in 1937.


By the early 1960s, scleral buckling became the method of choice when the development of new materials, particularly silicone, offered surgeons new opportunities for improving patient care. 

The buckling element is usually left in place permanently. The element pushes in, or “buckles,” the sclera toward the middle of the eye. This buckling effect on the sclera relieves the traction on the retina, allowing the retinal tear to settle against the wall of the eye. The buckle effect may cover only the area behind the detachment or it may encircle the eyeball like a ring. 

This procedure effectively holds the retina against the sclera until scarring seals the tear and prevents fluid leakage, which could cause further retinal detachment. Scleral buckles come in many shapes and sizes. The encircling band is usually a thin silicone band sewn around the circumference of the sclera of the eye. In rare instances, a metallic clip may be used. Some metallic clips may pose a risk to patients undergoing MRI procedures. 

Tantalum Clips
Tantalum clips were found to be less bulky than sutures, allowing the surgeon to adjust the tension of the circling band for the scleral buckle. Tantalum clips did not cause tissue reaction and did not harbor infection. Because tantalum is a non-ferrous metal (non-magnetic), these clips are considered to be acceptable for patients undergoing MRI procedures.

REFERENCES

Bakshandeh H, Shellock FG, Schatz CJ, Morisoli SM. Metallic clips used for scleral buckling: ex vivo evaluation of ferromagnetism at 1.5 T. J Magn Reson Imaging. 1993;3:559. 

Lincoff H. Radial buckling in the repair of retinal detachment. Int Ophthalmol Clin. 1976;16:127-34.

Michels RG. Scleral buckling methods for rhegmatogenous retinal detachment. Retina. 1986;6:1-49.



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