The treatment of giant tear detachments using retrohyaloidal perfluorocarbon gases without drainage or vitrectomy

In a pilot study, an expanding perflurocarbon gas was injected into the retrohyaloidal space for treating giant tear detachments. Using the balloon-gas procedure with a single gas injection, a bubble was obtained that was large enough to tamponade a giant tear without prior drainage of subretinal fluid or vitrectomy. The procedure was performed under subconjunctival anesthesia in order to preserve the patient's light perception, the fading of which served as a safeguard against excessive gas injection. The posterior hyaloidal membrane was only attached to the anterior flap of the tear and to the circumference of the retina anterior to the equator. The retrohyaloidal gas injection was not followed by star-fold formation or other evidence of preretinal proliferation. During the follow-up, the detached posterior hyaloidal membrane appeared to have collapsed on the anterior retina in concertina-like folds. Reattachment occurred in four of the five cases; no retina redetached during an average follow-up of 2 years.