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Giant retinal tears after prior pars plana vitrectomy: management strategies and outcomes

Authors Gonzalez MA, Flynn Jr HW, Smiddy WE, Albini TA, Berrocal AM, Tenzel P

Received 23 May 2013

Accepted for publication 10 June 2013

Published 27 August 2013 Volume 2013:7 Pages 1687—1691

DOI https://doi.org/10.2147/OPTH.S48930

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Marco A Gonzalez, Harry W Flynn Jr, William E Smiddy, Thomas A Albini, Audina M Berrocal, Paul Tenzel

Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA

Purpose: To evaluate management strategies and outcomes for patients with giant retinal tear (GRT)-associated retinal detachment (RD) that had undergone previous pars plana vitrectomy (PPV).
Methods: A noncomparative consecutive case series between January 2005 and July 2010. Patients with a preceding history of PPV undergoing retinal reattachment surgery for GRTs were identified.
Results: Using International Classification of Diseases 9 codes for GRTs, 227 cases were identified. A total of eight eyes in eight patients were identified as having had preceding PPV for non-RD-related pathology. The mean age was 45.5 (range of 10–79) years. The mean time between PPV and diagnosis of GRT was 2.4 months. The mean follow-up after RD surgery was 24.3 months. Presenting visual acuity was 20/400 or better in four of eight patients (50%). All patients underwent repeat PPV with either gas or oil tamponade. A scleral buckling procedure was performed in seven patients (88%). Perfluorocarbon liquid was used during reattachment surgery in four patients (50%). Although anatomic success was achieved in all patients, visual acuity at last follow-up was 20/400 or better in 6 patients (75%).
Conclusion: GRTs are an uncommon complication of PPV. The majority of patients underwent repeat PPV, scleral buckling procedure, perfluorocarbon liquid use and silicone-oil tamponade. Patients presenting with GRT-associated RD after PPV undergoing additional surgery achieved high rates of anatomic success, but visual outcomes were variable.

Keywords: giant retinal tear, retinal detachment, vitrectomy, perfluorocarbon liquids

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