Internal limiting membrane – ILM Peel

Internal limiting membrane – ILM Peel

The white outer layer of the eyeball is known as the sclera. When the retina (a layer of nerves on the inside of the eye) gets detached from its normal position, the patient faces visual issues, where he is unable to detect any image. In retinal detachment, the patient may complain of symptoms that include specks in their field of vision or flashes of light, appearing in both views, the peripheral (side) or in front. Immediate care is needed, and if delayed, then the condition may become complicated, which leads to permanent vision loss. In some cases, the retina does not completely detach from the eye but forms a tear. In both cases, the scleral buckle procedure can treat these issues.

A buckle is a silicone sponge, rubber, or semi-hard plastic material that the ophthalmologist applies on the sclera during the scleral buckle procedure. The eye surgeon sews the buckle to the sclera, which heals on its own. By sewing, this helps the eye to stay in its place.

Scleral buckling is a surgical procedure used to treat different types of retinal detachments and retinal tears.

The Procedure:

  • In the procedure of scleral buckling, subject to the patient’s retina, the surgeon may give general anesthesia where the patient will sleep through the treatment. In some cases, if the surgeon decides to do the procedure while allowing the patient to stay awake, the eye will be numbed through an injection or eye drops.
  • On the sclera, the surgeon makes an incision.
  • A buckle is stitched around the outer layer of the eye so that it doesn’t move. The buckle supports the retina and pushes the scleral towards the middle of the eye to close the tear.
  • After surgery, your doctor drains any fluid behind your retina and applies antibiotic eye drops to prevent infection.

To prevent a tear or detachment from reopening. Your doctor may also perform one of the following:

  • Laser photocoagulation. In this procedure, your doctor uses a laser beam to burn the area surrounding a retinal tear or detachment. This creates scar tissue, which helps seal a break and stops fluid leakage.
  • In this procedure, your doctor uses extreme cold to freeze the outer surface of the eye, which can cause scar tissue to develop and seal a break.

In the end, the surgeon drains any fluid from behind the retina and applies antibiotic eye drops to prevent any infection.


Scleral buckling can take about 45 minutes to complete. Recovery time is anywhere from two to four weeks. Your doctor will provide aftercare instructions. This includes information on when you can resume taking prescription medications, as well as instructions for medication prescribed to treat post-surgery pain.

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