SANDWICH TAMPONADE TECHNIQUE FOR THE MANAGEMENT OF GIANT RETINAL TEAR RETINAL DETACHMENT.

Abstract

Purpose: Controversy exists regarding the best intraocular tamponade for the management of giant retinal tear rhegmatogenous retinal detachment (GRT-RRD). We describe the 'sandwich' technique for the short-term post-operative tamponade of RRD associated with GRT.

Methods: Description of surgical technique and retrospective case series of eyes with GRT-RRD. Surgery consisted of 25-gauge pars plana vitrectomy (PPV) with heavy liquid (perfluoro-n-octane) and sulphur hexafluoride (100% SF6, 0.5 mL) gas used as post-operative intraocular tamponade, and removed after a mean of 11 (range 10-14) days with a second PPV with air tamponade.

Results: three eyes of three patients (mean age 64 years) with GRT-RRD involving the inferior retina (2 fovea sparing and 1 fovea involving) were treated with PPV and 'sandwich' tamponade. In all cases best corrected visual acuity improved, successful retinal reattachment was achieved, and there were no intraoperative and post-operative complications.

Conclusion: The 'sandwich' tamponade is a safe and effective short-term post-operative tamponade for GRT-RRD extending beyond the superior and inferior meridians. It has the advantage of providing tamponade to a large extensive GRT with no posturing requirement, and of avoiding ocular toxicity associated with the use of silicone oil.