During vitrectomy for dense vitreous haemorrhage, an 'en-bloc' technique is used. Which tamponade agent is preferred when a giant retinal tear (≥90°) is found during vitrectomy?

• A SF6 gas (20%) tamponade
• B Air tamponade alone
• C C2F6 gas (16%) tamponade
• D Perfluorocarbon liquid (PFCL) exchange followed by silicone oil ✓

Explanation

Giant retinal tears (GRT ≥ 90°) have a high risk of retinal flap slippage and reproliferation, requiring prolonged tamponade and precise retinal unfolding. PFCL (heavy liquid) is first injected to flatten and stabilise the retina and prevent posterior slippage, then exchanged for silicone oil to provide long-term tamponade. Gas alone is insufficient for GRTs due to inadequate duration and difficulty ensuring prone positioning adequacy.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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