The outcome of surgical management for giant retinal tear more than 180°

Abstract

BackgroundTo evaluate the surgical outcome for management of giant retinal tear (GRT) more than 180° by combined pars plana vitrectomy (PPV), encircling scleral buckle, 360° Laser endophotocoagulation, and silicon oil tamponade.MethodsThis was a Prospective, interventional case series study. Twenty four eyes of 23 patients suffering from GRT more than 180° underwent PPV combined with encircling scleral buckle and 360° laser retinopexy of the peripheral retina followed by silicon oil tamponade. All patients were followed up for at least six months.ResultsComplete anatomical success (retinal attachment after silicone oil removal) was achieved in 20 (83.3%) eyes at the end of follow-up, while incomplete anatomical success (retinal redetachment under or after removal of silicon oil) occurred in four (16.7%) eyes. At the end of follow-up period (mean of 13.7 months + 6.5), improvement of best-corrected visual acuity was achieved in 22 (91.7%) eyes. Preoperative best-corrected visual acuity ranged from HM to 0.15 while postoperative visual acuity ranged from HM to 0.9. Retinal slippage did not occur in any case. Additionally, removal of the clear crystalline lens in phakic eyes was not necessary in the primary intervention.ConclusionsGRT more than 180° can be effectively treated with PPV coupled with encircling scleral buckle, 360° laser retinopexy and silicon oil tamponade with no incidence of retinal slippage. In this complex procedure, concurrent encircling buckle the primary intervention may contribute to high chance of success.

Giant Retina Tear in an African Population: Presentation and Fellow Eyes

“…Similarly the extreme poor preoperative visual acuity noted in this group is similar to that documented in another study from Egypt [4]. In this study on GRT reported by sheriff; of the 24 participating eyes, only 3 eyes with attached macular had a readable visual acuity.…”

“…Idiopathic GRT, which has been noted as the commonest etiology by other studies, also occurred in the majority of eyes in this study [4] [5].…”

“…In this study on GRT reported by sheriff; of the 24 participating eyes, only 3 eyes with attached macular had a readable visual acuity. Preoperative best-corrected visual acuity (BCVA) ranged from hand motion (HM) to counting fingers (CF) in 21 macula-off eyes, while decimal BCVA in eyes with attached macula was 0.15 in two eyes and 0.05 in one eye [4].…”

“…Though cases of giant retina tear and detachment have been reported in several publications from western, wealthier nations, not much is know about the presentation of giant retina tear and detachment cases, the fellow eye and the surgical repair in an African context [1] [2] [3] [4]. The delay in presentation by the patients and scarce resources could prove to be a challenge in giant retina tear cases which are known to have a higher incidence of proliferative vitreoretinopathy (PVR) and are prone to recurrent retina detachment.…”

In Vitro Biocompatibility of Silicone Oil Siluron Xtra® on Porcine Retina in a Perfusion Culture System

“…While most commonly gas is used as an endotamponade during standard vitrectomy surgery, silicone oils have shown good post-operative results in the treatment of persistent macular holes [3] and especially in more complicated procedures such as giant retinal tear [4] and patients with retinal detachment due to proliferative diabetic retinopathy [5] and proliferative vitreopathy [6]. Usually, air or expanding gases are used as an endotamponade for macular holes in vitrectomy surgery [7][8][9].…”