Nadeem Qureshi, Mohammad Abbas, Nadeem Ishaq, Mohammad Mumtaz, Mustafa Abdul Hameed.
Management of giant retinal tears with vitrectomy, internal tamponade and 360° retinal photocoagulation without Scleral Buckling.
J Rawal Med Coll Jan ;10(2):70-2.

Background: To determine the effectiveness of Vitrectomy, internal tamponade and 360° peripheral retinal photocoagulation without scleral buckling in the management of giant retinal tears (GRTs). Methods: Sixteen eyes of 16 consecutive patients with GRTs were operated at Al-Shifa trust eye hospital from 2000 to 2004. None of them had previous vitreoretinal surgery. Eyes included in this study underwent pars plana vitrectomy, perfluorocarbon liquid and silicone oil exchange. Retinopexy was applied to the edges of the tear through endolaser photocoagulation and extended over 360° to the peripheral attached retina. No scleral buckle was placed in any of these cases. Results: The GRT was 180° or greater in four eyes and 90° to 180° in twelve eyes. The lower edge of the GRT was located in the inferior quadrant in fourteen eyes. Proliferative Vitreous Retinopathy (PVR) was grade A in five eyes, grade B in eight eyes and grade C in three eyes. In 12 (75%) of the 16 eyes, the retina was successfully reattached after surgery and the silicone oil was removed after a mean period of twelve weeks. Two of the four eyes were successfully reoperated by performing relaxing retinotomies. At the end of the follow up, the retina was reattached in 14 (87.5%) of the 16 eyes. The mean follow up period was 14 months (range 5 -23 months). Conclusions: The success rate of management of GRTs with pars plana vitrectomy, internal tamponade and 360° photocoagulation of the retina without scleral buckle is high.

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