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

Purpose: Controversy exists regarding the best intraocular tamponade for the management of giant retinal tear (GRT) rhegmatogenous retinal detachment (RRD). We describe the “sandwich” technique for the short-term postoperative 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 with heavy liquid (perfluoro-n-octane) and sulfur hexafluoride (100% sulfur hexafluoride, 0.5 mL) gas used as postoperative intraocular tamponade, and removed after a mean of 11 (range 10–14) days with a second pars plana vitrectomy with air tamponade. Results: Three eyes of three patients (mean age 64 years) with GRT RRD involving the inferior retina (two fovea sparing and one fovea involving) were treated with pars plana vitrectomy and “sandwich” tamponade. In all cases, best corrected visual acuity improved, successful retinal reattachment was achieved, and there were no intraoperative and postoperative complications. Conclusion: The “sandwich” tamponade is a safe and effective short-term postoperative 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.