What is the composition of a scleral buckle?

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Scleral Buckle Composition

Scleral buckles are most commonly made of solid silicone rubber, which is currently the most popular and practical material due to its softness, ease of handling, and excellent tissue tolerance. 1

Primary Material Options

Solid Silicone Rubber (Most Common)

  • Solid silicone rubber is the standard material for modern scleral buckles due to its optimal combination of properties including softness, ease of surgical manipulation, and biocompatibility 1
  • Silicone bands and elements are used in various configurations including thin solid bands and thicker oval elements that produce predictable buckling effects 2
  • The material is well-tolerated by ocular tissues and maintains its structural integrity long-term 1

Silicone Sponge (Alternative)

  • Silicone sponge is also widely used and offers the advantage of greater softness compared to solid silicone 1
  • This material provides excellent conformability to the scleral surface 1

Hydrogel Implants (Specialized)

  • Hydrogels, particularly the MAI implant developed by Refojo, represent an ideal scleral implant material with several advantages 1
  • These implants are extremely soft, resist damage from sutures, have smooth surfaces, and are available in multiple sizes and shapes 1
  • The small pore structure prevents microorganism penetration, and the material can be saturated with water-soluble antibiotics preoperatively for prolonged postoperative antibiotic release 1

Historical and Alternative Materials

Absorbable Materials (Largely Obsolete)

  • Donor tissue including autogenous fascia lata, plantaris gracilis tendon, or cadaveric dura mater, sclera, and fascia lata 1
  • Specially prepared gelatin was the most useful among absorbable synthetic materials including reconstituted collagen, absorbable gut, fibrin, blood plasma, air, and sodium hyaluronate 1
  • These materials have been largely replaced by nonabsorbable implants which have proven more practical 1

Specialized Configurations

  • Expandable implants exist in both temporary and permanent forms, utilizing silicone balloons filled with liquid 1
  • Magnetic buckles containing permanent magnets based on neodymium-iron-boron powders embedded in medical-grade silicone have been investigated experimentally for additional retinal fixation capabilities 3

Clinical Considerations

Material Selection Impact

  • The choice of buckle material affects surgical outcomes, with solid silicone rubber providing the most reliable and predictable results 1
  • Buckle geometry (radius, thickness, width) influences ocular deformation, with the initial undeformed radius having dominant influence on eye deformation 4
  • The thickness and width of the buckle have minimal influence on deformation and may be selected primarily for patient comfort 4

Surgical Adjuncts

  • When sclera is too thin or weak to tolerate sutures, surgical adhesives such as isobutyl cyanoacrylate can be used 1
  • Exposed buckles may require coverage with preserved scleral patches (full or half thickness) sutured over the silicone with Tenon's and conjunctiva closure 5

References

1
Research

Scleral implants: an historical perspective.

Survey of ophthalmology, 1991

4
Research

On the behavior of an eye encircled by a scleral buckle.

Journal of mathematical biology, 2017

5
Research

Scleral patch for exposed silicone buckles.

Ophthalmic surgery, 1975

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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