[Management of giant retinal breaks].

PURPOSE: To evaluate the management for eyes with retinal detachment due to giant retinal breaks. METHODS: Retrospectively, we reviewed 33 eyes of 32 cases treated either by scleral buckling (2 eyes) or by pars plana vitrectomy (PPV) combined with 20% C3F8(3 eyes) or silicone oil (28 eyes) tamponade. Of the 31 eyes undergone PPV, lensectomy was also performed on 20 eyes and perfluorocarbon was used to unroll and flatten the flap of the giant retinal breaks (GRBs) as well as to help peeling membranes in 27 eyes. Cryopexy (9 eyes) or endophotocoagulation (24 eyes) was applied to close the GRBs. RESULTS: After follow-up for 6-42 months (mean 16.97 +/- 9.88), total retinal reattachment was achieved in 26 eyes, macular reattachment in 4 eyes, and 3 eyes maintain detached. Of the reattached 30 eyes, the final acuity were less than 0.02 in 4 eyes, 0.02-0.04 in 3 eyes, 0.05-0.08 in 2 eyes, 0.1-0.3 in 14 eyes, 0.4-0.7 in 7 eyes. CONCLUSION: A majority of GRBs eyes may avoid blindness by appropriate surgical methods and intraocular tamponade according to the complexion of the GRBs. Early diagnosis and operation of GRBs are the main prerequisites of a better prognosis and results. Proliferative vitreo retinopathy (PVR) was the main cause of surgical failure.