In the management of giant retinal tear (GRT ≥90°), what is the MOST important intraoperative consideration that distinguishes it from routine retinal detachment repair?

• A Need for silicone oil tamponade over gas tamponade
• B Use of 360° scleral buckle as primary treatment
• C Mandatory prophylactic PRP to the fellow eye
• D Prevention of posterior flap slippage using perfluorocarbon liquid (PFCL) ✓

Explanation

In GRT, the posterior flap of the tear has a tendency to fold and 'slip' posteriorly due to vitreous traction, hindering retinal reattachment and causing double-layer folds. Perfluorocarbon liquid (PFCL, e.g., perfluorodecalin) is instilled to unfold and stabilise the posterior flap during surgery. Silicone oil is often the preferred final tamponade due to the need for long tamponade in the inferior retina, but PFCL use during surgery is the key distinguishing step. Scleral buckle alone cannot manage GRT reliably.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.