This is a case shared by Dr. Daniel Louzada from São Paulo – Brazil

This is a case of a patient with a inferior Giant Retinal Tear in his right eye. We can see also a PVR A in the border of the tear and the peripheral vitreous.
In these cases, we normally don’t need to place a buckle, once the giant retinal tear works as a retinectomy.

It’s important perform radical excision removing as much as possible the vitreous base under scleral indentation. Heavy liquids are very useful in these cases once it helps to keep the flap down and to remove all the subretinal fluid.

A key point in this procedure is to remove all the fibrosed and folded border of the flap. You can use endocautery in this step to avoid or control bleeding.
In cases of giant tears, the retina in the area of the break may slip during PFCL removal creating retinal folds. You can avoid slippage by removing thoroughly the subretinal fluid during FAX.
Start removing PFCL until is just posterior to the edge of the break. Then keep your canula on the interface between BSS and PFCL. You can turn the eye away from the tear while aspirating the subretinal fluid. When the tear is completely dry, you can remove the remain PFCL over the optic disk.
If it doesn’t work, it’s possible to perform direct fluid against oil exchange.

Watch our other videos on Giant Retinal Tear and Fluid against oil Exchange.
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Video:
Daniel Louzada - São Paulo 🇧🇷
Edition:
Filipe Lucatto MD
Juliana Prazeres – MD
Salvador - 🇧🇷

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