[Retinal detachments caused by giant tear].

Area of Science:

• Ophthalmology
• Retinal Surgery

Background:

• Giant retinal tears (GRTs) exceeding 70 degrees present significant surgical challenges.
• Retinal detachment with folded posterior flaps complicates surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of endocular surgery versus conventional extraocular surgery for retinal detachment with giant tears.
• To compare outcomes for folded versus non-folded retinas following different surgical approaches.

Main Methods:

• Retrospective analysis of 52 eyes from 50 patients with GRTs.
• Comparison of conventional extraocular surgery (20 eyes) with endocular surgery (vitrectomy plus internal tamponade with air or silicone oil) (32 eyes).
• Assessment of surgical success rates, considering pre-operative retinal folding and post-operative complications like retinal retraction.

Main Results:

• Conventional surgery had limited success (42.85% for non-folded, 0% for folded retinas).
• Endocular surgery achieved an 87.50% initial success rate.
• Post-operative retinal retraction reduced success rates to 45.45% (non-folded) and 52.38% (folded) retinas.

Conclusions:

• Endocular surgery demonstrates superior initial results for giant retinal tears, particularly those with folded retinas.
• Strategies to minimize secondary retinal retraction include complete vitrectomy, judicious cryopexy, and timely laser photocoagulation.
• Further research into effective antiproliferative drugs is needed to combat post-operative cellular proliferation and contraction.