Scleral Buckle Surgery: Treating Retinal Detachment
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is scleral buckle surgery?
Scleral buckle surgery is a procedure that repairs a detached retina by pushing the white outer wall of the eye, the sclera, toward the detached retina. A piece of silicone or sponge is secured on the eye to create an indentation so the retina can reattach. [1] It is usually an outpatient procedure, and recovery takes about two to four weeks. [1]
Emergency warning
Retinal detachment is a medical emergency. [1] [2] Go to an eye doctor or the emergency room right away if you suddenly see many more floaters or flashes of light than usual, or a dark shadow or “curtain” over part of your vision. [2] You can read more about eye floaters and retinal tears in our guides.
What the research says
Buckling and vitrectomy have similar reattachment rates. A meta-analysis of 41 studies (5,401 buckle eyes and 10,546 vitrectomy eyes) found that reattachment rates were similar with both approaches after the first operation (about 85% to 87%) and overall (about 97% to 98%). The buckle caused fewer cataracts and fewer new retinal breaks but more choroidal detachment, bleeding under the retina, and leftover fluid beneath the retina (Dhoot et al., Surv Ophthalmol, 2022 [3]).
Randomized trials show little difference for simple detachments. A Cochrane review of 10 randomized trials (1,307 eyes) found little or no difference between vitrectomy and buckling in first-operation reattachment (risk ratio 1.07; low-certainty evidence), in final success (about 94 vs 96 per 100 people), or in vision. Cataracts were more common after vitrectomy (risk ratio 1.71), and choroidal detachment was more common after buckling (Znaor et al., Cochrane Database Syst Rev, 2019 [4]).
A buckle alone may work better than buckle plus vitrectomy. In a meta-analysis of 18 studies (7,212 eyes), the buckle alone had a slightly higher final reattachment rate (97.4% vs 93.9%) and a lower risk of cataract (risk ratio 0.34) than a buckle combined with vitrectomy, with similar vision results (Nichani et al., Ophthalmologica, 2022 [5]).
What Is Scleral Buckle Surgery?
Scleral buckle surgery, also called scleral buckling, is a specialized eye procedure that repairs a detached retina. In retinal detachment, the light-sensitive layer at the back of the eye pulls away from the tissues that support it. [1] Because this can lead to permanent vision loss, prompt surgery is essential. [2] The “buckle” is a piece of silicone or sponge attached to the sclera, the white part of the eye, to support the retina while it reattaches. [1] The buckle is usually left in place permanently unless a complication arises.
Scleral buckling is an older procedure, and it has become less common as vitrectomy has become more common, possibly because buckling can have a more difficult recovery. [1] Even so, a buckle, alone or combined with another procedure, may be the best treatment for some people. [1] Which surgery you have depends on the condition of your vitreous (the gel inside the eye), whether you have your natural lens or an implanted lens, and whether you can hold your head in a certain position after surgery. [1]
How does scleral buckle surgery work?
The goal is to close any retinal tears and push the eye wall into contact with the detached retina. This indentation, or “buckling,” reduces the pull on the retina and lets it heal in its correct position.
Component | Description | Purpose in Surgery |
Scleral Buckle | A silicone band or sponge. | Indents the eye wall to support retinal reattachment. [1] |
Cryotherapy or Laser | Freezing or light energy. | |
Fluid Drainage | Removal of fluid from behind the retina, when needed. [1] | Helps the retina settle flat against the eye wall. |
When is scleral buckle surgery needed, and what are common causes?
Surgeons may recommend scleral buckling for rhegmatogenous retinal detachment, the most common type. [1] Aging is the usual cause, and other factors raise the risk. [1] Scleral buckling may also be used if your retina has detached again after earlier treatment. [1]
Risk Factor | Impact on Eye Health |
Aging | Natural changes in the eye can lead to retinal tears and detachment. [2] |
Eye Injuries | |
Very Nearsighted Eyes | |
Previous Eye Surgeries |
What happens during scleral buckle surgery?
Scleral buckle surgery is usually an outpatient procedure and takes about an hour to an hour and a half. [1] Before surgery, tell your ophthalmologist about every medicine, supplement, and over-the-counter product you take. [1] Your provider will tell you when to stop any medicines and when to stop eating and drinking the night before. [1] You will need a responsible driver to take you home. [1]
Sedation and anesthesia: You receive a sedative through a vein, plus local anesthesia (numbing the eye), regional anesthesia, or general anesthesia. You must stay completely still. [1] Read more in our guide to anesthesia types, safety, and recovery.
Preparation: Eye drops widen your pupil, and an instrument called a speculum keeps your eye open. [1]
Placing the buckle: The surgeon makes a cut in the conjunctiva (the clear covering over the sclera) and places the buckle around the eye. It may look like a complete band or like sponges on either side of the detachment. [1]
Extra treatments: The surgeon may use lasers or freezing to help the retina stay in place, and may remove fluid from behind the retina. [1]
What is recovery and aftercare like after scleral buckle surgery?
After surgery you receive an antibiotic to help prevent infection, and you stay at the surgery center until you wake up and your driver can take you home. You wear an eye patch for the rest of the day and maybe the next day, and you return the next day for a follow-up visit. [1] Recovery generally takes two to four weeks, or a bit longer. [1]
Immediate post-operative care
You may have a sore eye, which you can usually manage with over-the-counter pain relievers if your provider approves. [1] Limit your activities for a few days. [1]
Activity restrictions
Ask your provider for exact timelines for showering or bathing, returning to work or school, driving, strenuous activity such as sports or heavy lifting, and swimming. [1]
When to call your provider
Call your provider or get medical help if your eye is swelling, your eyesight gets worse, or you have extreme pain. [1]
What are the success rates and risks of scleral buckle surgery?
According to some estimates, the success rate of scleral buckle surgery is as high as 80% to 90%. [1] The National Eye Institute similarly notes that treatment for retinal detachment succeeds for about 9 out of 10 people, although some people need a second treatment or surgery if the retina detaches again. [2] Possible complications include double vision, bleeding in the eye, infection, becoming more nearsighted, cataracts, higher pressure in the eye, and another retinal detachment or tear. [1]
Conclusion
Scleral buckle surgery remains an important and often successful treatment for retinal detachment. By supporting the eye wall, it lets the retina reattach and helps protect your vision. Recovery takes patience and careful attention to your surgeon’s advice, and your surgeon can explain whether a buckle, vitrectomy, or a combination is best for you. If vision loss does occur, see our guide to living with low vision.
What are the next steps if you need scleral buckle surgery?
If you notice sudden flashes of light, many new floaters, or a “curtain” over your vision, get emergency medical care right away. After surgery, go to all follow-up visits and follow your surgeon’s activity restrictions closely. Protecting your eyes from injury, for example with safety goggles during risky activities, and getting regular dilated eye exams can help protect your long-term vision.
Trusted resources: Cleveland Clinic: Scleral Buckle, National Eye Institute: Retinal Detachment.
Frequently Asked Questions
What is a scleral buckle made of?
A scleral buckle is made of silicone or a sponge-like material.
Is the buckle removed after the eye heals?
No. The buckle is usually left in place permanently unless a complication arises.
Will I be awake during the surgery?
You receive a sedative through a vein plus local, regional, or general anesthesia. You need to be completely still, and you will not feel pain.
How long does the surgery take?
Scleral buckle surgery usually takes an hour to an hour and a half.
Can I drive home after the procedure?
No. You need a responsible driver to take you home because of the sedative and anesthesia.
How long is the total recovery time?
Recovery usually lasts two to four weeks, and sometimes a bit longer.
Will my vision return to normal immediately?
No. Vision often takes time to settle after surgery. Ask your provider what to expect for your eye.
What are the warning signs of a detached retina?
A sudden increase in floaters, flashes of light, or a dark shadow or curtain over part of your vision. This is a medical emergency.
Is scleral buckling better than a vitrectomy?
It depends on your eye. Research shows similar reattachment rates for simple detachments, and your surgeon considers the condition of your vitreous, whether you have a natural or implanted lens, and whether you can hold your head in a certain position.
Can a scleral buckle cause double vision?
Yes. Double vision is a possible complication of the surgery. Tell your provider if you notice it.
Does the surgery increase nearsightedness?
Scleral buckle surgery can. You may become more nearsighted after the procedure.
Who is a candidate for scleral buckling?
Scleral buckling is mainly used for rhegmatogenous retinal detachment, the most common type, or if the retina has detached again after earlier treatment. Aging is the usual cause, and your surgeon decides which operation suits your eye.
How successful is the procedure?
The success rate is as high as 80% to 90% by some estimates, and some people need a second treatment.
When can I resume exercise?
Ask your provider. Strenuous activity, heavy lifting, and swimming need your provider’s approval, and timelines vary.
What should I do if my eye pain worsens?
Call your provider or get medical help right away if you have extreme pain, eye swelling, or worsening eyesight.
Related Reading
Retinal Detachment: Symptoms, Causes, Diagnosis & Treatment — Complete Guide explains retinal detachment warning signs and urgent treatment.
Retinal Tear: Symptoms, Causes, and Treatment Options describes retinal tears and how they are sealed before detachment.
Vitrectomy: Restoring Vision Through Specialized Eye Surgery explains the gel-removal surgery often used for detachment.
Eye Floaters: Causes, Symptoms & When to Seek Urgent Care covers floaters and when they signal an eye emergency.
References
Cleveland Clinic. Scleral Buckle. Cleveland Clinic. June 9, 2023. https://my.clevelandclinic.org/health/treatments/25063-scleral-buckle
National Eye Institute. Retinal Detachment. National Eye Institute. November 5, 2025. https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/retinal-detachment
Dhoot AS, Popovic MM, Nichani PAH, et al. Pars plana vitrectomy versus scleral buckle: a comprehensive meta-analysis of 15,947 eyes. Surv Ophthalmol. 2022;67(4):932-949. PMID 34896191. https://doi.org/10.1016/j.survophthal.2021.12.005
Znaor L, Medic A, Binder S, et al. Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments. Cochrane Database Syst Rev. 2019;3(3):CD009562. PMID 30848830. https://doi.org/10.1002/14651858.CD009562.pub2
Nichani PAH, Dhoot AS, Popovic MM, et al. Scleral buckling alone or in combination with pars plana vitrectomy for rhegmatogenous retinal detachment repair: a meta-analysis of 7,212 eyes. Ophthalmologica. 2022;245(4):296-314. PMID 35533652. https://doi.org/10.1159/000524888
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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