Surgery for retinal detachment in patients with giant retinal tear: etiologies, management strategies, and outcomes

Ophthalmic Surg Lasers Imaging Retina. May-Jun 2013;44(3):232-7. doi: 10.3928/23258160-20130503-04.

Abstract

Background and objective: To evaluate etiologies, management, and outcomes for patients with giant retinal tears undergoing initial surgery at a single institution.

Patients and methods: Noncomparative, retrospective, consecutive case series at a university referral center including 79 eyes of 77 patients.

Results: Blunt trauma constituted 22% of cases. All patients underwent pars plana vitrectomy with gas or silicone oil tamponade. Eighty-five percent (67 eyes) underwent an encircling scleral buckle. Perfluorocarbon liquids were used in 71% (61 eyes). Eighteen percent (14 eyes) underwent re-operation for recurrent retinal detachment. Ninety-two percent (73 eyes) achieved anatomic success with one or more surgical procedures. Visual acuity at last follow-up was at least 20/400 in 84.9% of patients (28 of 33) with 3 clock hours compared to 65.2% (30 of 46) with tears greater than 3 clock hours.

Conclusion: Patients with giant retinal tear undergoing surgery achieved high rates of anatomic success, but re-operations were frequent. Better visual outcomes were associated with smaller circumferential dimensions in the giant retinal tears.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reoperation / statistics & numerical data
  • Retinal Detachment / surgery*
  • Retinal Perforations / pathology
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Scleral Buckling*
  • Silicone Oils / administration & dosage
  • Visual Acuity
  • Vitrectomy*
  • Young Adult

Substances

  • Silicone Oils