title: [Giant retinal tears treated with lens sparing, bimanual 23 g vitrectomy without scleral buckle].
abstract: BACKGROUND
  A giant retinal tear is defined as a full thickness break in the neurosensory retina that extends circumferentially for 3 or more clock hours around the retina in the presence of a posterior vitreous detachment. It is one of the more complex surgical scenarios that a retina surgeon can face. There is no consensus on the ideal surgical technique; however, the "traditional" approach has been to perform a combined procedure including lensectomy, scleral buckle and vitrectomy.
  
  
  OBJECTIVE
  To report the outcome over 2 years of five patients with giant retinal tears managed with lens sparing, bimanual 23-gauge vitrectomy without scleral buckle.
  
  
  METHODS
  Retrospective analysis of patients with giant retinal tears managed with lens sparing, bimanual 23-gauge vitrectomy without scleral buckle. Included in the analysis were age, lens status, etiology and size of the tear, pre- and postoperative visual acuity, anatomic success, tamponade used, laser or criopexy where recorded.
  
  
  RESULTS
  Three patients had high myopia, one secondary to blunt trauma and one with Wagner-Stickler syndrome were included in the analysis. The size of the tear varied from 120-280°. Anatomic success was achieved in all patients. One patient developed proliferative vitreoretinopathy and was re-operated and the retina remained attached.
  
  
  CONCLUSIONS
  In this group of selected patients, lens-sparing bimanual 23-gauge vitrectomy without scleral buckle seems a safe and effective option in the management of retinal detachment associated with giant retinal tears. Further prospective and comparative studies are warranted to establish the role of this technique in the treatment of patients with this complex pathology.
authors.affiliation: California Retina Consultants, Santa Barbara, California, USA. quezadarc@hotmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quezada-Ruiz
authors.affiliation: Departamento de Retina y Vítreo, Instituto de Oftalmología Fundación Conde De Valenciana, Mexico.
authors.forename: Rene Alfredo
authors.initials: RA
authors.lastname: Cano-Hidalgo
mesh_terms: D005131:Eye Injuries / Q000601:surgery; D006801:Humans; D009216:Myopia / Q000150:complications; D012162:Retinal Degeneration / Q000150:complications; D012163:Retinal Detachment / Q000150:complications / Q000601:surgery; D012167:Retinal Perforations / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D016896:Treatment Outcome; D053675:Versicans / Q000172:deficiency; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000601:surgery
chemical_list: D053675:Versicans
keywords: cerclaje; desgarro gigante; desprendimiento de retina; giant retinal tear; retinal detachment; scleral buckle; vitrectomy; vitrectomía