[Surgical management for giant retinal tear].

OBJECTIVE

To study the effect of surgical management for giant retinal tear (GRT).

METHODS

A standard three-point vitrectomy with silicone oil intraocular injection was performed on 41 cases. Of them, scleral buckling was also performed on 35 cases and lensectomy, on 17 cases. The basal vitreous gel and peri-retinal membranes were resected completely in all the cases. Air-fluid exchange, retinal tack or liquid perfluorocarbon were used to unroll and flatten the flap of the GRTs. Cryopexy or endophotocoagulation were applied to close the GRTs.

RESULTS

In the follow-up for 3-39 months (mean 11.6 months), total retinal attachment was achieved in 29 cases, macular retinal attachment in 7 cases, and no retinal attachment in 5 cases. The final visual acuities were 0.01-0.05 in 6 cases, 0.06-0.1 in 17 cases, 0.2-0.5 in 11 cases and 0.6-1.0 in 2 cases.

CONCLUSIONS

The key factor of successful operation is to unroll and flatten the flap of GRTs completely. Scleral buckling shows advantages and disadvantages, while appropriate scleral buckling is necessary in GRTs with proliferative vitreo-retinopathy. Postoperative further proliferation is the main factor affecting the long term effect of the treatment.