R.D. by giant tear: Experience in eight cases treated with vitrectomy and perfluorocarbons

Abstract

We present our experience in the surgical treatment of retinal detachment by giant tear, applied in 8 eyes of 7 consecutive patients between December 1992 and January 1994. Two eyes were emmetropes and six had myopia and a history of blunt trauma was obtained in only one. In one patient giant tear appeared some months later in the controlateral eye. The surgical technique used included three port vitrectomy with or without scleral buckle, lensectomy in some cases, intraoperative manipulation with perfluorocarbon liquid, endolaser or cryopexia and fluid-gas exchange. In all cases perfluoropropane (C3F8) 14% was the long-term retinal tamponade. Perfluorocarbon was effective in unfolding the giant retinal flap in all cases. In three of them, non of whom had inverted posterior retinal flap, perfluorocarbon displaced subretinal fluid to peripheral retinal break and drained through it. In one case, that extended for 340°, no circumferential scleral buckle was used. In three cases, two emmetropes and one with myopia less than 10 diopters, no lensectomy was performed. Of these three, two who had preexisting lens opacities showed development of the same, and extracapsular cataract surgery with posterior chamber lens was performed in one. The retina was successfully reattached in all eyes (100%) and no PVR or macular epiretinal membranes were noted in the follow-up period. In our experience vitrectomy and perfluorocarbon were an effective treatment for achieving retinal reattachment in retinal detachment by giant tear.