Surgical treatment and outcome of patients with giant retinal tears

Objective To report the management and outcome in retinal detachments associated with giant retinal tears (GRTs). Methods Retrospective, case note analysis of patients treated between November 1991 and June 2002 at a tertiary referral hospital. Results The case notes of 29 patients ( 24 males, 5 females) with a follow-up ranging from five months to 7 years were reviewed. In all, 25 eyes had retinal detachments with macular involvement and 10 patients had myopia more than 6D. All patients underwent vitrectomy. A total of 23 patients had heavy liquid and 16 had scleral explants; 28 patients had silicone oil and one had C3F8 tamponade. Intraoperative complications included lens trauma and iatrogenic GRT. Six eyes had recurrent retinal detachment and needed multiple surgical procedures. At the last follow-up, 25 patients had anatomically attached retinas. In all, 18 fellow eyes were treated prophylactically. Three patients had total retinal detachment and marked PVR. The visual acuity improved in 20 eyes. Conclusion GRTs are more common in patients with high myopia. With newer techniques of surgical treatment of GRTs, the anatomical and visual outcomes are more favourable.