Open Globe Management

Alessandro A. Castellarin, MD; Dante J. Pieramici, MD


Compr Ophthalmol Update. 2007;8(5):111-124. 

In This Article

Role of Prophylactic Scleral Buckle

Some authors have recommended that all eyes with posterior ruptured globe should have an encircling scleral buckle placed at the time of the repair even if no retinal detachment is present.[40] Several reasons have been advocated: 1) In case of dense vitreous hemorrhage, some retinal tears may be undetected. 2) Vitreous may incarcerate in scleral lacerations, and later traction may lead to a retinal tear or retinal detachment. 3) Early placement of an encircling band is easier, as there is less scar tissue and the muscles are more easily isolated. Several studies have tried to resolve the issue.[41,42,43]

Despite numerous studies, there are no substantial data to indicate whether a scleral buckle might decrease the subsequent risk of retinal detachment or even reduce the need for secondary surgical intervention. However, if the scleral and retinal laceration extends posterior to the ora serrata, if the peripheral retina cannot be visualized, and in case of retinal incarceration, a prophylactic scleral buckle should be considered.


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