Implementation of a scleral buckle is a surgery used to repair a retinal detachment in which a silicone band is attached to the eye surface, forming an indent or “buckle.” A vitrectomy is a procedure used to repair a retinal detachment or remove vitreous, blood, or membranes from the inside of the eye that may be impairing vision.
The following is a brief outline of what to expect immediately after surgery and guidelines for long-term care after scleral buckle and vitrectomy procedures.
What to Expect
After the procedure, you will be sent home with a patch and a shield. Leave these in place until your follow-up doctor visit, usually the following day. Your doctor will remove the patch and shield, and your eye will likely appear red, swollen, or bruised. There may be some crust or drainage. You may experience a dull pain or scratchy feeling for a few days after surgery, and therefore acetaminophen is recommended to alleviate some of this discomfort if needed.
Post-Operative Home Care
You will receive an eye box and prescription drops or ointments. Bring the eye box to your first appointment, and the nurse will show you how to use it properly. You should also bring all prescriptions to discuss with your doctor. Do not use any drops in the affected eye the first night unless your doctor tells you explicitly to do so. However, you may use any usual prescription drops in the other eye. Be sure to always wash your hands before administering eye drops to reduce the chance of infection. If redness of the eye or lids occurs after using drops, stop using them and call your doctor. This can be a sign of an allergy.
Using the Eye Box
Wash your hands thoroughly with soap and water for at least 20 seconds. Dry completely. Soak the cotton balls in the eyewash solution. Rest the moistened cotton against your closed eye for a few seconds to loosen any crust, then gently wipe from inner to outer corner. If both eyes were treated, use a separate cotton ball for each eye to avoid spreading infection.
Using the Shield and Patch
Wear the metal shield at night and during naps for at least a week. This protects the healing eye from injury while you are asleep. Ask your doctor before you discontinue use to ensure you’re healed enough.
Wear the patch outdoors for comfort and protection. You can also wear dark glasses if you find that light causes you some discomfort.
Sometimes an air bubble is injected into the eye during a vitrectomy to maintain the eye’s shape. Your doctor will inform you about special positions to hold and precautions to take if you have such a bubble. You will not be able to drive, work, or exercise during this phase, and you will need to sleep with your head elevated. It’s very important to follow your doctor’s directions precisely to allow for optimal healing after this particular surgery.
Unless your doctor recommends otherwise, you may return to light work as soon as you feel ready. But as a precaution, avoid the following activities:
– Lifting objects heavier than 30 pounds
– Bending from the waist
– Strenuous exertion
– Chopping, pounding, or jerking movements
– If you are suffering from violent sneezing or coughing, talk to your doctor. This can damage your healing tissues.
Gentle exercise, including climbing stairs in moderation and without rushing, can get you some physical activity without risk to your eye. Exposure to cold air while walking outdoors is also safe.
If your vision allows, you can resume watching television, using the computer, or reading. But check with your doctor before resuming activities such as driving.
Take care when showering or washing your hair to avoid getting water or soap into your eye, and use a mild shampoo. You may prefer to have your hair washed while leaning backward into a sink to avoid this issue altogether.
It’s also very important to call your doctor if you experience any of the following issues:
– Pain that is not controlled by over-the-counter medications
– Nausea or vomiting; this may be a sign of dangerously high eye pressure
– Increased swelling or redness of the eye
– A decrease in vision
These procedures are well studied and very successful. With proper after-care, you can expect a very positive prognosis.