Objective: To explore the methods of lens-sparing (without lensectomy), non-silicone oil tamponade and no scleral buckling for treatment of early giant retinal tears.
Methods: Thirteen cases of early retinal detachment of proliferative vitreoretinopathy (PVR) grade C2-D1, with giant tear extending from 135 degrees to 270 degrees were chosen. Transscleral cryotherapy was first applied to treat each end of the giant tear up to the oral serrate. And then conventional three-port pars plana vitrectomy was performed. Perfluorodecalin liquid was injected to manipulate the flap of the retinal tear. The flap with no cryotherapy before was treated with endolaser or cryotherapy under optimal visual condition, then air-fluid was exchanged completely and C3F8 was injected properly.
Results: With a mean follow-up of 8.2 months, the retina was reattached completely in 12 eyes. Success rate was 92.3%, and visual acuity improved. Most postoperative complications were slight. The retina failed to reattach only in 1 case with severe vitreous blood.
Conclusions: In treating early retinal giant tears without severe PVR, the lens-sparing, non-silicone oil tamponade and no scleral bucking are helpful to simplify operation and to improve the success rate of the retinal surgery and to yield satisfactory outcome of visual acuity. Besides, it can also avoid the initial side effects of silicone oil tamponade and diopter irregularity after lensectomy.