Management of giant retinal tears using microincision vitrectomy surgery

Giant retinal tears (GRTs; ≥90°) are rare and difficult to treat successfully for even experienced vitreous surgeons. Using microincision vitrectomy surgery (MIVS) to treat GRTs has been an important advancement. Here we describe the surgical technique and its complications. Surgical Technique: Initially, the eye is carefully vitrectomized with MIVS using a modern wide-viewing system and chandelier illumination. Perfluorocarbon liquid (PFCL) is then gently injected. After endophotocoagulation, the PFCL is exchanged for silicone oil (SO) for a 2-week course of intraocular tamponade. Complete retinal reattachment and visual recovery are achieved after the SO is removed. Complications: Postoperative complications in the retina include macular pucker, subretinal PFCL, retinal folds, cystoid macular edema, and redetachment due to proliferative vitreoretinopathy. All complications can be resolved with medication or surgery. Conclusions: The techniques for MIVS offer a feasible new approach for treating eyes with GRTs. In combination with intraoperative use of PFCL and a 2-week course of SO tamponade, MIVS is highly recommended to all vitreous surgeons seeking an excellent rate of reattachment.