Role of intraoperative 360 retinal endophotocoagulation in the management of giant retinal tears

ABSTRACT

To determine the effectiveness of intraoperative 360 degree retinal photocoagulation in the management of giant retinal tears [GRTs]. Departments of Vitreoretina, Al Shifa Trust Eye Hospital, Rawalpindi. From 2000 to 2004. Sixteen eyes of 16 consecutive patients with GRTs were operated at Al Shifa trust eye hospital. Eyes included in this study underwent pars plana vitrectomy, perfluorocarbon liquid injection, 360 degree retinal photocoagulation and silicone oil exchange. Retinopexy was applied to the edges of the tear through endolaser photocoagulation and extended over 360 degree to the peripheral attached retina. No scieral bijckle was placed in any of these cases. The extent of the GRT was 180 degree or greater in four eyes and 90 degree to 180 degree in twelve eyes. The lower edge of the GRT was located in the inferior quadrant in fourteen eyes. 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 360 degree laser photocoagulation. 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 retinal was reattached in 14 [87.5%] of the 16 eyes. The mean follow up period was 14 months [range 5-23 months]. The success rate of management of GRTs with pars plana vitrectomy, internal temponade and 360 photocoagulation of the retina without scleral buckle is high