Surgical Roundtable Case 1: Managing Giant Retinal Tears

Mrinali Gupta, MD, FASRS, demonstrates surgical repair of a traumatic giant retinal tear (GRT) detachment in a 50-year-old phakic patient.

By: Christina Y. Weng, MD, MBA, Mrinali Gupta, MD, FASRS, Nimesh A. Patel, MD, Frank Brodie, MD, MBA

Retinal Physician July 1, 2026 Vol 23, Issue July-August 2026 Page(s): 6

Clinical Report: Managing Giant Retinal Tears

Background

Giant retinal tears are a rare but serious form of retinal detachment, occurring in approximately 1-2% of rhegmatogenous retinal detachments. Effective management is crucial due to the high risk of complications such as proliferative vitreoretinopathy. Understanding the surgical techniques and approaches can improve patient outcomes in these complex cases.

Data Highlights

No numerical data or trial data was provided in the source material.

Key Findings

A low-lying scleral buckle is recommended for managing phakic GRTs.
Complete vitreous shaving before perfluorocarbon (PFO) injection can reduce the risk of subretinal PFO.
It is important to truncate the anterior retinal flap during surgery.
Slow drainage through the GRT and drying the GRT edge prior to PFO removal minimizes retinal slippage.

Clinical Implications

Surgeons should consider the use of a low-lying buckle in GRT repairs to support the abnormal vitreous space and mitigate the risk of complications. Additionally, meticulous surgical techniques, including careful drainage and PFO management, are essential for optimal outcomes.

Conclusion

The management of giant retinal tears requires a combination of surgical skill and strategic planning to ensure successful outcomes. Sharing techniques among surgeons can enhance the overall quality of care in this challenging area.

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