A scleral buckle is a piece of silicone sponge, rubber, or semi-hard plastic. In scleral buckling surgery, the buckle is placed against the outer surface of the eye and sewn onto the eye to keep it in place. The buckle pushes the sclera toward the middle of the eye, relieving the pull on the retina and allowing the tear to settle against the wall of the eye.

Extreme cold (cryopexy) or light (laser photocoagulation) is used to scar the area around the tear. The scarring helps keep this area from moving so that a seal can form between the retina and the layer beneath it. In most cases, the buckle will stay on the eye forever.