The outcome of surgical management for giant retinal tear more than 180°

BACKGROUND: To evaluate the surgical outcome for management of giant retinal tear (GRT) more than 180° by combined pars plana vitrectomy (PPV), encircling scleral buckle, 360° Laser endophotocoagulation, and silicon oil tamponade. METHODS: This was a Prospective, interventional case series study. Twenty four eyes of 23 patients suffering from GRT more than 180° underwent PPV combined with encircling scleral buckle and 360° laser retinopexy of the peripheral retina followed by silicon oil tamponade. All patients were followed up for at least six months. RESULTS: Complete anatomical success (retinal attachment after silicone oil removal) was achieved in 20 (83.3%) eyes at the end of follow-up, while incomplete anatomical success (retinal redetachment under or after removal of silicon oil) occurred in four (16.7%) eyes. At the end of follow-up period (mean of 13.7 months + 6.5), improvement of best-corrected visual acuity was achieved in 22 (91.7%) eyes. Preoperative best-corrected visual acuity ranged from HM to 0.15 while postoperative visual acuity ranged from HM to 0.9. Retinal slippage did not occur in any case. Additionally, removal of the clear crystalline lens in phakic eyes was not necessary in the primary intervention. CONCLUSIONS: GRT more than 180° can be effectively treated with PPV coupled with encircling scleral buckle, 360° laser retinopexy and silicon oil tamponade with no incidence of retinal slippage. In this complex procedure, concurrent encircling buckle the primary intervention may contribute to high chance of success.