Purpose:
To evaluate etiologies, surgical techniques, and outcomes for patients undergoing retinal reattachment surgery in the setting of a known giant retinal tear.
Methods:
This is a non-comparative consecutive case series from January 2005 through July 2010. Patients 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:
A total of 40 eyes in 40 patients were identified. The mean age was 49.6 years (range of 8 to 79). 22 patients (55%) were male. The mean follow up after surgery was 13.5 months. Presumed etiology of giant retinal tear was trauma (32.5%), high myopia (17.5%), recent cataract surgery (15%) and lattice degeneration (15%). Presenting visual acuity was equal or better than 20/200 in 14 of 40 patients (35%). All patients underwent pars plana vitrectomy with either gas or oil tamponade. 29 patients (72.5%) underwent scleral buckle procedure in addition to vitrectomy. 19 patients (47.5%) had perfluorocarbon use during reattachment surgery. 2 out of 40 patients required re-operation for recurrent retinal detachment. Visual acuity improved to better than or equal to 20/200 in 27 patients (67.5%). 39 of 40 patients achieved anatomic success at the last follow up examination.
Conclusions:
Trauma was a common associated factor in patients presenting witih giant retinal tear associated retinal detachments. The majority of patients in the study period underwent combined pars plana vitrectomy and scleral buckle procedure. Perfluorocarbon use varied depending on the extent of retinal pathology on presentation. Patients presenting with giant retinal tears undergoing retinal reattachment surgery achieved high rates of anatomic and visual success.
Keywords: retinal detachment • retina • visual acuity