Surgical success in the management of retinal detachment secondary to a giant retinal tear

Abstract

Background: The purpose of this study was to describe anatomical and visual outcomes after scleral buckling, pars plana vitrectomy, and the use of silicone oil as a tamponade in the management of retinal detachment associated with giant retinal tears (GRT). Material and methods: A retrospective descriptive chart review was conducted for cases with an initial presentation of rhegmatogenous retinal detachments associated with GRT. Patients underwent surgical management by a single surgeon and had follow-ups at least 12 months. Results: We included 32 eyes of 32 patients. All eyes underwent 23G pars plana vitrectomy with scleral buckling and silicone oil as tamponade. Lensectomy was performed for all phakic eyes. Mean pre-operative best-corrected visual acuity (BCVA) was 20/800, and post-operative was 20/40 (20/20-LP). The mean follow-up was 18 months. Fourteen eyes (45%) had grade C proliferative vitreoretinopathy, and five eyes (16%) had GRT more than 180º. The primary reattachment rate was 93%, and the overall final anatomical success rate was 100%. Transient intraocular pressure (IOP) elevation was found in 6 (19%), and after silicone oil removal surgery, no patient required antihypertensive management. Conclusion: High rates of anatomical success support the management of GRT-associated retinal detachment with scleral buckling, lensectomy, par plana vitrectomy, and the use of silicone oil as tamponade. Removal of silicone oil helps to avoid complications secondary to its emulsification, such as glaucoma and band keratopathy.