Results of 12-year clinical study of giant retinal tear

To evaluate the surgical results of scleral buckling alone on eyes with retinal detachment with giant retinal tears of less than 120 degrees, without inverted flap or proliferative vitreoretinopathy, and vitrectomy combined with scleral buckling with or without intraoperative usage of perfluorocarbon liquid (PFCL) in complicated cases.

Retrospectively, we reviewed giant retinal tear cases treated at Chang Gung Memorial Hospital, Kaohsiung, Taiwan between January 1, 1989 and August 31,2000. The surgical techniques consisted of standard three-port pars plana vitrectomy combined with scleral buckling in complicated cases, PFCL used intraoperatively in later cases, and scleral buckling alone in minor cases.

A total of 47 consecutive eyes with giant retinal tears with retinal detachment in 45 patients with no previous history of ocular penetrating injury or vitreoretinal operations were enrolled in this study. The follow-up period was at least three months for all patients. Thirty-four eyes (72.3%) had giant retinal tears of less than 180 degrees, 12 eyes (25.5%) had tears between 180 degrees and 270 degrees, and one eye had two giant retinal tears. Scleral buckling combined with vitrectomy was performed in 36 complicated eyes (76.6%), PFCL was used intraoperatively later in 24 eyes, and scleral buckling was used alone in 11 minor cases (23.4%). Thirty eyes (63.8%) gained reattachment after the first surgery. Altogether, the retinas of 38 of 47 eyes (80.9%) remained attached at the last follow-up examination.

In minor cases of giant retinal tear, scleral buckling alone without vitrectomy may be considered the primary surgical procedure. In complicated cases, using PFCL intraoperatively not only affords many advantages during surgery, but also raises the retinal reattachment rate.