Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 10-year follow-up.

A total of 39 eyes of 39 patients, previously reviewed 5 years after vitrectomy and fluid/silicone oil exchange for giant retinal tears, were reexamined after 10 years. The retina remained attached in 30 eyes (77%), and in no case had redetachment occurred in the interval between 5 and 10 years after surgery. In all, 3 groups of eyes were identified, 20 eyes with attached retinas and visual acuities of 6/60 or better (group I), 10 with attached retinas and vision of less than 6/60 (group II) and 9 in which the retina was detached (group III). Eyes in group I were found to be stable, with future improvement anticipated in some cases with cataracts. A majority of group II eyes were deteriorating due to glaucoma and keratopathy. Failure in group III was due to proliferative vitreoretinopathy in all except one instance. Measures aimed at reducing the incidence of epiretinal membrane proliferation, glaucoma and keratopathy are recommended to improve long-term results in the treatment of retinal detachments complicated by giant retinal tears. These include the use of safer methods of retinopexy, preservation of the lens when possible, early removal of silicone oil and a reduction in the use of scleral buckles.