Giant retinal tears

The results of operation on 38 of 47 consecutive retinal detachments associated with giant retinal tears are presented. Giant tears can be grouped into 4 types, the first 3 being fairly specific and the last, a heterogeneous group excluding the first 3 types and comprising somewhat more than half of the total number. The 4 types are: giant retinal dialysis; narrow peripheral giant tears; giant tears with inverted retinal flaps; the remainder. The first 2 types have a very good prognosis, the 3rd a very poor prognosis and the last the same prognosis as the series overall. Trauma does not seem to be an adverse prognostic factor because it tends to produce giant tears falling into the favorable types 1 and 2. High myopia, aphakia and the presence of severe vitreous traction, shown by fixed star folds or massive vitreous retraction, are adverse prognostic factors. Also, in the group of adverse prognostic factors is the association of a giant tear with certain genetically determined systemic disorders such as the Ehlers Danlos syndrome, Marfan's syndrome, Pierre Robin syndrome and Down's syndrome.