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Review
. 2017 Jan-Mar;12(1):93-97.
doi: 10.4103/2008-322X.200158.

Management of Giant Retinal Tear Detachments

Maria H Berrocal  1 , Megan L Chenworth  2 , Luis A Acaba  3
Affiliations
Review

Management of Giant Retinal Tear Detachments

Maria H Berrocal et al. J Ophthalmic Vis Res. 2017 Jan-Mar.

Abstract

Giant retinal tears (GRTs) are full-thickness circumferential tears of more than 90 degrees of the retina that are associated with vitreous detachment. They are related to ocular trauma, high myopia, aphakia, pseudophakia, genetic mutations involving collagen and young age. GRTs comprise 1.5% of all rhegmatogenous retinal detachments and the average age of incidence is 42 years. GRTs are more common in males, as 72% of all cases occur in males. The incidence of GRTs in the general population is estimated to be 0.05 per 100,000 individuals. Common techniques used in the management of GRTs include fluid-air exchange, pneumatic retinopexy, scleral buckling, primary vitrectomy with gas or silicone oil tamponade, and combined scleral buckle-vitrectomies. However, management of GRTs poses a great challenge to physicians due to the high risk of intra- and post-operative complications and the many technical difficulties involved. The advent of perfluorocarbon liquids (PFCL) and the use of micro-incisional surgery for the treatment of GRTs has provided new opportunities for the management of GTRs. Today, retinal reattachment can be achieved in 94-100% of cases.

Keywords: Giant Retinal Tears; Micro-incisional Surgery; Perfluorocarbon Liquids.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Giant Retinal tear of 180°.
Figure 2
Figure 2
Injection of PFCL with a dual-bore cannula to unfold retina.
Figure 3
Figure 3
Removal of the anterior vitreous in the corners of the tear.
Figure 4
Figure 4
Scleral depression with chandelier illumination in a phakic eye to trim the anterior retinal flap.
Figure 5
Figure 5
Laser applied to the edges of the GRT.
Figure 6
Figure 6
Removal of ERMs with forceps through the PFCL bubble.
Figure 7
Figure 7
Rows of laser photocoagulation around the 360° GRT.
Figure 8
Figure 8
Direct silicone oil/PFCL exchange with remaining PFCL bubbles on the surface of the retina.
See this image and copyright information in PMC

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