[Prospective study of 34 retinal detachments associated with giant retinal tear].

PURPOSE: To report the anatomical and functional outcomes of vitrectomy with silicone oil tamponade in the treatment of retinal detachment associated with giant retinal tears due to various factors.

METHODS

We prospectively followed 34 eyes of 33 patients with giant retinal tear. That underwent vitrectomy, injection of perfluorocarbon liquids and silicone oil tamponade. Scleral buckle was associated with vitrectomy in cases of inferior giant retinal tear; 26,5 % and 11,8 %, respectively, demonstrated pseudophakia and aphakia. Seven eyes (20,5 %) had a history of trauma (blunt injuries in four and a penetrating injury in three) and, 14 eyes (41,2 %) had severe myopia. One patient developed a bilateral giant retinal tear during the follow-up.

RESULTS

Retinal attachment was obtained in 33 (97 %) of 34 eyes, with a mean follow-up of 14,5+/-6 months. Retinal detachment reoccurred in four eyes (11,6 %) under silicone oil, in one eye (2,9 %) during the silicone removal, and in two eyes (5,8 %) after silicone removal and cataract surgery. Silicone oil was removed from all eyes (4,3+/-1 months). The most frequent postoperative complication was cataract in ten of 18 phakic eyes (55,5 %). Functional success with visual acuity 0,4 or better was obtained in 18 cases (52,96 %).

CONCLUSION

Pars plana vitrectomy with silicone oil tamponade proved to be highly effective in giant retinal tears in terms of the anatomical and functional results. The analysis of recurrent retinal detachment allowed us to refine the technique and to suggest scleral buckle in one case of inferior retinal tear with laser over 360 degrees .