Background: New techniques adapted for vitrectomy surgery, including the use of silicone oil and perfluorocarbon liquids, have been applied very successfully to giant retinal tears. Most surgeons thus turn immediately to vitrectomy for all giant tears. The authors have found that patients with giant tears usually have such rapid flow of fluid from the vitreous to the aqueous that repeated paracenteses can be performed without shallowing the anterior chamber, thus allowing injection of sufficient gas into the vitreous cavity to unroll and tamponade the giant tear without the need for vitrectomy. This makes pneumatic retinopexy a feasible alternative for those selected fresh giant tears that have mobile flaps and extend less than 180 degrees.
Methods: Five consecutive patients with giant retinal tears were treated with pneumatic retinopexy using paracentesis and two or more gas injections. They were followed at least 2 years.
Results: Four of the five tears were successfully reattached, although a new tear developed in one, and scleral buckling surgery was performed 11 months after the pneumatic retinopexy.
Conclusion: The authors conclude that pneumatic retinopexy is a reasonable alternative for selected patients with giant retinal tears.