Purpose
To evaluate incidence, surgical techniques, and outcomes for patients with giant retinal tear (GRT) associated retinal detachment (RD) that had undergone previous pars plana vitrectomy (PPV).
Methods
This is a non-comparative consecutive case series from January 2005 through July 2010. Patients with a preceding pars plana vitrectomy undergoing retinal reattachment surgery at Bascom Palmer Eye Institute in the presence of giant retinal tears were identified. Data was collected on demographics, clinical features, surgical techniques, anatomic success and visual outcomes.
Results
227 cases of ICD-9 coded GRTs were identified. A total of 9 eyes in 9 patients were identified as having had preceeding PPV for non-RD related pathology. The mean age was 42.1 years (range of 10 to 79). The mean time between PPV and diagnosis of giant retinal tear was 2.3 months. The mean follow up after RD surgery was 30.1 months. Presenting visual acuity was 20/400 or better in 5 of 9 patients (56%). All patients underwent repeat PPV with either gas or oil tamponade. 8 patients (89%) underwent scleral buckle procedure. 4 patients (44%) had perfluorocarbon use during reattachment surgery. Visual acuity improved to 20/400 or better in 6 patients (67%). 8 of 9 patients (89%) achieved anatomic success at the last follow up examination.
Conclusions
Giant retinal tears are an uncommon complication of PPV. The majority of patients underwent combined pars plana vitrectomy and scleral buckle procedure. Patients presenting with giant retinal tear associated RD after previous PPV undergoing additional surgery achieved high rates of anatomic and visual success.
Keywords: 697 retinal detachment •
762 vitreoretinal surgery •
688 retina