[Retinal detachments caused by giant tear].

52 eyes in 50 patients have been treated for a retinal detachment with a giant tear extending over at least 70 degrees. 27 eyes had an inverted posterior retinal flap covering the posterior pole. Conventional extraocular surgery was performed on 20 eyes. There was no success in 6 folded cases and a 42,85% success rate in 14 non-folded retinas. Endocular surgery by vitrectomy plus internal tamponade using air or silicone oil was done on 32 eyes with an 87,50% success rate at the end of surgery. Post-operative retinal retraction reduced the success rates to 45,45% for non-folded cases and 52,38% with folded retinas. There is no question in our mind about the value of endocular surgery for folded retinas. We think that endocular surgery is also the best choice for non folded retinas because of the excellent initial results. Secondary retraction phenomena are caused by endocular cellular proliferation and membrane formation and contraction. We presently try to minimize these by avoiding excess cryopexy, performing a vitrectomy as complete as possible and treating the reattached retina as soon as possible by argon laser photocoagulation. An efficient and safe antiproliferative drug is definitely needed.