Long-Term Results of Pars Plana Vitrectomy and Silicone Oil for Giant Tears

Abstract

PPV with SOI proved highly effective in GT. Proliferative vitreoretinopathy was the main cause of surgical failure and a frequent obstacle to silicone oil removal. The risks of redetachment have to be evaluated especially carefully when dealing with the only eye.

Low Redetachment Rate Due to Encircling Scleral Buckle in Giant Retinal Tears Treated With Vitrectomy and Silicone Oil

“…In this study, 43% of the eyes had a postoperative VA of Յ0.1, while Karel et al, 24 who also studied patients after a longer follow-up period, found that 70% had a VA Յ0.1 (Table 4). In our study 57% of the patients had a postoperative VA better than 0.1, and 60% had an equal or better postoperative VA than preoperative, which is comparable to results reported earlier by others.…”

“…In other studies, the percentage of eyes from which the silicone oil was not removed at the end of the follow-up period was much higher 5,24,32 (Table 4). For instance, Scott et al 32 reported that in their series 41% still had silicone oil tamponade at the end of the follow-up period (Table 4).…”

“…1,[3][4][5]15,24,32,34 Final success rates in most studies are approximately 95%. 1,3,4,15,24,32 Anatomic success rates vary depending on the operation technique, whether eyes with traumatic GRT or PVR are included, the length of follow-up, and whether the silicone oil is removed from the eye at the end of the follow-up period. Although most authors report their results after a maximum follow-up of 6 months (Table 4), the mean follow-up period in our series was 4 years, with all patients having a follow-up of at least 1 year or longer ( Table 2).…”

Surgical treatment and outcome of patients with giant retinal tears

“…Due to their high surface tension, retinal breaks can be closed internally, without the heavy liquid flowing into the subretinal space. Glaser et al 16 showed that, in GRTs complicated by severe PVR, the use of heavy liquids to flatten the retina followed by longacting gas tamponade yielded a significantly better outcome compared to fluid air exchange and silicone oil tamponade. Similarly, they also demonstrated the efficacy of heavy liquid flattening of GRTs with inverted flaps in the absence of PVR.…”

“…14 The use of perfluorocarbons (heavy liquids) as an adjunctive tool has made unfolding and stabilisation of the retina easier. 15,16 The use of silicone oil has also been proven to be more effective in early visual rehabilitation, 17 and is also safer to exchange with perfluorocarbons.…”