Giant retinal tear retinal detachment etiologies, surgical outcome, and incidence of recurrent retinal detachment after silicone oil removal.

Purpose: The purpose of this study was to evaluate etiologies, management, and outcomes of patients with giant retinal tears (GRTs) undergoing primary surgery at a tertiary referral center.

Methods: This was a retrospective, consecutive case series of 94 patients with at least 3 months follow-up after silicone oil removal (SOR). Fifty-seven eyes (60.6%) underwent vitrectomy, 36 eyes (38.3%) underwent combined vitrectomy with buckling, and 1 eye (1.1%) underwent scleral buckling. Perfluorocarbon liquid (PFCL) heavy liquid to flatten GRT flap intraoperative has been used then PFCL air exchange then air-silicon exchange in all eyes undergoing vitrectomy. Fellow eye was observed for retinal detachment (RD).

Results: Idiopathic cause constitutes 47 eyes (50%), in which 25 eyes (26.6%) are myopic and 22 eyes (23.4%) have a history of trauma. Eighty-five eyes (90.4%) achieved anatomic success. Visual acuity at the last follow-up was at least 20/400 in 71 eyes (75.5%) of patients. Recurrent RD after SOR was found in 21 eyes (22.3%), of which 50% had proliferative vitreoretinopathy grade C (PVR-C) or more ( = 0.03) and 20% had GRT size more than 180° ( = 0.04). Pars plana vitrectomy (PPV) alone ( = 0.89) or combined PPV with buckling ( = 0.98) has no significant correlation with recurrent RD. Twenty-one percent of the fellow eye had RD.

Conclusion: Idiopathic cause constitutes the majority (50%). Patients with GRT who underwent surgery achieved a high anatomic success rate. PVR-C or more and GRT size more than 180° remain the most significant risk factor for recurrent RD after SOR, whereas PPV alone or combined PPV with buckling has no significant correlation with recurrent RD.