LOW REDETACHMENT RATE DUE TO ENCIRCLING SCLERAL BUCKLE IN GIANT RETINAL TEARS TREATED WITH VITRECTOMY AND SILICONE OIL FLEUR GOEZINNE, MD, ELLEN C. LA HEIJ, MD, PHD, TOS T. J. M. BERENDSCHOT, PHD, SACHA T. J. M. GAST, MD, ALBERT T. A. LIEM, MD, PHD, IGOR L. LUNDQVIST, MD, FRED HENDRIKSE MD, PHD Background: The goal of this study was to identify risk factors for redetachment and to assess long-term anatomic and functional results of pars plana vitrectomy (PPV) for retinal detachment associated with giant retinal tears (GRT). Subjects and Methods: In a retrospective study the authors analyzed 30 eyes which were operated with PPV for GRT retinal detachment in their clinic between March 1998 and August 2003. Results: Redetachment rate after one vitrectomy procedure in this series of 30 eyes was 30% (n = 9), and ultimately, the retina was attached in 29 (96.7%) eyes. After multivariate analysis the absence of an encircling scleral buckle (P = 0.008) was signifi- cantly associated with redetachment. Visual acuity improved in 54% of the eyes. Conclusion: Vitrectomy with an encircling scleral buckle seems to be a preferred treatment for complicated retinal detachments due to GRT. RETINA 28:485– 492, 2008 G iant retinal tears (GRT) are retinal breaks that extend over 3 clock hours or more in circumfer- ence. 1 Treatment of choice is a pars plana vitrectomy (PPV) 2–8 with reposition of the inverted central retinal flap using perfluorocarbon liquids, 9 endolaser, 4 or cryocoagulation and tamponade of the retina using silicone oil. 5,6,10 In addition, some surgeons prefer to use an encircling scleral buckle or a scleral buckle for a portion of the circumference. The goal of this study was to identify risk factors for redetachment and as- sess the long-term results of PPV for retinal detach- ment due to GRT. Materials and Methods In this retrospective study we included all cases with giant retinal tears (GRT) which were operated with a vitrectomy technique in our clinic between March 1998 and August 2003 by three surgeons (F.H., E.L.H., and A.L.). The following preoperative clinical characteristics of the patients were collected for statistical analysis: age, sex, preoperative trauma, the size of the GRT in clock hours, the number of detached quadrants of the retina, whether the central area of the macula (foveal region) was involved in the detachment, and the pres- ence and grade of proliferative vitreoretinopathy From the Department of Ophthalmology, University Hospital Maastricht, The Netherlands. The authors have no proprietary or commercial interest. Reprint requests: F. Goezinne, MD, Department of Ophthalmology, University Hospital Maastricht, P.O. Box 5800, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands; e-mail: fgo@soog.azm.nl 485