Current management of giant retinal breaks: results with vitrectomy and total air fluid exchange in 95 cases

These results indicate that vitrectomy is a valuable adjunct in the management of giant retinal breaks with a partial or complete inversion of the posterior retinal flap. Removal of the vitreous gel makes possible the injection of a large bubble of air to more optimally unfold the posterior retinal flap. In addition, vitrectomy severs the equatorial membrane that can cause postoperative circumferential extension of the giant retinal break or the formation of new retinal tears. A 360 degree scleral buckle is mandatory in giant retinal breaks with a partial or complete inversion of the posterior retinal flap. Unless there are medical contraindications, the air fluid exchange should be carried out in the prone position.