Mechanisms of failure in the repair of large retinal tears.

An analysis of large tears treated over a decade revealed that while dialyses responded well to circumferential buckling, horseshoe tears responded poorly. A circumferential intrusion of the globe augmented the redundancy of the posterior edge of long tears and predisposed to leaking radical folds. Tears up to 70 degrees responded favorably to radical buckles, often without drainage of subretinal fluid. Beyond 70 degrees and initial procedure with cryopexy and a gas tamponade without buckling reattached the retina occasionally, and if not, would at least reduce the problem to one manageable by local buckling techniques with a more favorable prognosis.