Management for retinal detachment associated with Giant Retinal Tear скачать в хорошем качестве

Management for retinal detachment associated with Giant Retinal Tear

In this video shared by Dr. Francyne Veiga from Ribeirão Preto - Brazil, we highlight some key points on vitrectomy secondary to Giant retinal tear cases.  After core vitrectomy, it is important to remove all the condensed vitreous along the anterior edge 360º with scleral depression. The anterior flap of the GRT needs to be trimmed also, to prevent peripheral ischemia, PVR and traction.Remove the folded and fibrosed border of the retinal flap. You can use an endodiathermy to avoid unnecessary bleeding in this step. After gently repositioning the retinal flap, the PFCL is gradually injected over the optic disc with displacement of the subretinal fluid anteriorly. Be careful about the jet stream during PFCL injection because of the risk of migration of the heavy liquid to the subretinal space. In this case, the surgeon had to make two retinotomies to remove the Perfluor bubbles before continuing the surgery. After endolaser around the tear, another key point in these cases is the Fluid air exchange.  It is really important to carefully remove all the subretinal fluid to avoid retinal slippage. You can start removing perfluor until it is just posterior to the edge of the tear. Then you thoroughly remove the BSS, keeping your aspiration on the interface of it with the PFCL. You can help the subretinal fluid removal by turning the eye away from the tear while aspirating the remaining BSS. Alternatively, direct fluid against silicone oil exchange can be performed.  Video: Francyne Veiga MD Riberão Preto - 🇧🇷 Edition: Filipe Lucatto MD Juliana Prazeres MD Salvador - 🇧🇷