[Management of very complicated retinal detachment]

To evaluate the management for a group of complicated retinal detachment in very severe conditions including(A) rhegmatogenous retinal detachment associated with severe posterior and anterior PVR, (B) giant retinal tear (GRT) retinal detachment with severe PVR, (C) severe perforating eye injury with tractional retinal detachment.

A total number of 31 eyes from 31 patients was included, in which 14 eyes were in group A, 8 eyes were group B and 9 eyes group C. Procedures including scleral buckling, encircling, cryotherapy, total vitrectomy, epiretinal membrane peeling/excision, relaxing retinectomy, use of perfluorocarbon liquid and silicone oil were applied to all patients. Patients were followed up for three to 16 months.

Retinas of 21 out of 31 eyes(67.7%) were completely reattached and 5 eyes (16.1%) were partially reattached, 5 eyes were failed(16.1%). Postoperative vision was significantly improved in 25 eyes. The visual acuity of 19 eyes was better than 0.02, while before operation only two eyes were better than 0.02. PVR and GRT patients had better results.

The results showed that a big part of very complicated retinal detachment which was called as hopeless cases could still be successfully treated with comprehensive procedures, more than half of them may have useful vision which may obviously improve their life quality.