Giant retinal tears vs primary rhegmatogenousretinal detachments : A study with the purpose of comparing postoperative results and complications

Abstract: Introduction Giant retinal tears (GRT) are rare and difficult to treat. Today, there are seven centers inSweden where this complicated form of rhegmatogenous retinal detachment (RRD) can betreated. Despite the technical and surgical advances in the last decades, the ideal treatment isstill unknown. In the end, the choice is made by an individual surgeon, without much researchto back it up.In contrast, a mild form of RRD is considered easier to handle. Previous studies describe asingle surgery success rate of over 90% for this form of RRD. This is higher compared togiant retinal tears, where the rate is 70-90%. Purpose The purpose of this study was to compare the postoperative results and complications of giantretinal tears with a mild type of rhegmatogenous retinal detachment. Method This is a retrospective cohort study of 18 patients with GRT treated at USÖ between 2013-2017. The GRT sample was matched with the same number of patients with a mild form ofRRD treated at USÖ between 2011-2019. The period before, under and after surgery wereinvestigated to compare results and complications. Results Several factors with statistical significance were found: the single surgery success rate ishigher in GRT; the number of reoperations is less when an outlier has been removed; thefrequency of glaucoma and residual silicone oil are higher in GRT; the rate of preoperativeepiretinal membranes is higher in RRD, and the portion of preoperative proliferativevitreoretinopathy (PVR) is higher in GRT. Conclusion Somewhat surprisingly, the results present a higher single surgery success rate in GRT thanthe mild form of RRD. Compared to literature the rate for RRD is relatively low, but the ratefor GRT is among the best compared to other studies. However, this may be due to the smallsample size and potential bias in the matching. Before surgery GRT presents with worsepreoperative visual acuity and higher rate of complications. These differences seem to shrinkafter surgery. The exception being glaucoma, which is more common in GRT