title: Giant retinal tears after prior pars plana vitrectomy: management strategies and outcomes.
abstract: OBJECTIVE
  To evaluate management strategies and outcomes for patients with giant retinal tear (GRT)-associated retinal detachment (RD) that had undergone previous pars plana vitrectomy (PPV).
  
  
  METHODS
  A noncomparative consecutive case series between January 2005 and July 2010. Patients with a preceding history of PPV undergoing retinal reattachment surgery for GRTs were identified.
  
  
  RESULTS
  Using International Classification of Diseases 9 codes for GRTs, 227 cases were identified. A total of eight eyes in eight patients were identified as having had preceding PPV for non-RD-related pathology. The mean age was 45.5 (range of 10-79) years. The mean time between PPV and diagnosis of GRT was 2.4 months. The mean follow-up after RD surgery was 24.3 months. Presenting visual acuity was 20/400 or better in four of eight patients (50%). All patients underwent repeat PPV with either gas or oil tamponade. A scleral buckling procedure was performed in seven patients (88%). Perfluorocarbon liquid was used during reattachment surgery in four patients (50%). Although anatomic success was achieved in all patients, visual acuity at last follow-up was 20/400 or better in 6 patients (75%).
  
  
  CONCLUSIONS
  GRTs are an uncommon complication of PPV. The majority of patients underwent repeat PPV, scleral buckling procedure, perfluorocarbon liquid use and silicone-oil tamponade. Patients presenting with GRT-associated RD after PPV undergoing additional surgery achieved high rates of anatomic success, but visual outcomes were variable.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Gonzalez
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: William E
authors.initials: WE
authors.lastname: Smiddy
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Albini
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.forename: Paul
authors.initials: P
authors.lastname: Tenzel
keywords: giant retinal tear; perfluorocarbon liquids; retinal detachment; vitrectomy
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