[Pars plana vitrectomy with implantation of silicone oil in surgery forvery large retinal tears].

The authors evaluate the results of pars plana vitrectomy (PPV) with intravitreal implantation of silicon oil (ISO) in 19 eyes of 17 patients with gigantic tears of the retina. During the mean observation period of 22 months the operation was successful in 15 of 19 eyes (78%). The retina adhered on the entire surface in 12 eyes (65%), in three eyes (15%) there remained a defined flat elevation of the retina in the periphery of the lower half of the fundus which did not go as far as the macula. In successfully operated eyes the visual acuity was 0.4 in two eyes, visual acuity of 0.3-0.1 in 7 eyes and visual acuity less than 0.1, making spatial orientation possible, in six eyes. The cause of reduced visual acuity of successfully operated eyes were macular abnormalities which were associated with the fundamental disease, degenerative myopia, injury, impaired nurture of the macula during prolonged detachment, a membrane-forming process. As to late complications of ISO, the most frequent were glaucoma in 42% and complicated cataract u 78% phakic eyes. Extraction of a cataract with iridectomy VI and supplementation of silicon oil into the intravitreal space did not cause in any of the patients a relapse of detachment of the retina. The final evaluation of PPV with ISO in the surgery of gigantic lesions of the retina will be possible only after the long-term follow up of larger groups of patients.