Ghosh Y K, Banerjee S, Savant V, Kotamarthi V, Benson M T, Scott R A H, Tyagi A K
Department of Vitreo-retinal Surgery, Birmingham and Midland Eye Centre, City Hospital, NHS Trust, Dudley Road, Birmingham B18 7QU, UK.
Eye (Lond). 2004 Oct;18(10):996-1000. doi: 10.1038/sj.eye.6701390.
To report the management and outcome in retinal detachments associated with giant retinal tears (GRTs).
Retrospective, case note analysis of patients treated between November 1991 and June 2002 at a tertiary referral hospital.
The case notes of 29 patients (24 males, 5 females) with a follow-up ranging from five months to 7 years were reviewed. In all, 25 eyes had retinal detachments with macular involvement and 10 patients had myopia more than 6 D. All patients underwent vitrectomy. A total of 23 patients had heavy liquid and 16 had scleral explants; 28 patients had silicone oil and one had C3F8 tamponade. Intraoperative complications included lens trauma and iatrogenic GRT. Six eyes had recurrent retinal detachment and needed multiple surgical procedures. At the last follow-up, 25 patients had anatomically attached retinas. In all, 18 fellow eyes were treated prophylactically. Three patients had total retinal detachment and marked PVR. The visual acuity improved in 20 eyes.
GRTs are more common in patients with high myopia. With newer techniques of surgical treatment of GRTs, the anatomical and visual outcomes are more favourable.
报告与巨大视网膜裂孔（GRT）相关的视网膜脱离的治疗及预后情况。
对1991年11月至2002年6月在一家三级转诊医院接受治疗的患者进行回顾性病例分析。
回顾了29例患者（24例男性，5例女性）的病例记录，随访时间为5个月至7年。共有25只眼发生视网膜脱离并累及黄斑，10例患者近视度数超过6D。所有患者均接受了玻璃体切除术。共有23例患者使用了重液，16例使用了巩膜外垫压物；28例患者使用了硅油，1例使用了C3F8填充。术中并发症包括晶状体损伤和医源性GRT。6只眼发生复发性视网膜脱离，需要多次手术。在最后一次随访时，25例患者的视网膜解剖复位。共有18只对侧眼接受了预防性治疗。3例患者发生了完全性视网膜脱离和明显的增殖性玻璃体视网膜病变（PVR）。20只眼的视力有所改善。
GRT在高度近视患者中更为常见。随着GRT手术治疗新技术的出现，解剖和视觉预后更为良好。
