A SURGICAL APPROACH TO LARGE SUBRETINAL HEMORRHAGE USING PARS PLANA VITRECTOMY AND 360° RETINOTOMY. Issue 8 (August 2015)

• Record Type: Journal Article
• Authors: Wei, Yantao; Zhang, Zhaotian; Jiang, Xintong; Li, Fan; Zhang, Ting; Qiu, Suo; Yang, Yuanzhe; Zhang, Shaochong
• Is Part Of: Retina. Volume 35:Issue 8(2015:Aug.)
• Publication Date: 2015-08
• Subjects: retinotomy -- silicon oil -- subretinal hemorrhage -- vitreous hemorrhage -- vitrectomy; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000000501
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To evaluate the surgical approach of pars plana vitrectomy combined with 360° retinotomy and silicon oil tamponade in the treatment of patients with large subretinal hemorrhage. Methods: Prospective, nonrandomized, and noncomparative case series study. Consecutive patients with breakthrough vitreous hemorrhage and massive subretinal hemorrahge were recruited to have combined surgery of pars plana vitrectomy with 360° retinotomy and silicone oil temponade. The main outcomes were best-corrected visual acuity, retina status, and postoperative complications. Results: Twenty-one patients (21 eyes) were included. The mean follow-up was 19.9 ± 7.4 months. The mean preoperative thickness of subretinal hemorrhage was 4.25 ± 0.69 mm. All the patients were observed to have choroidal neovascularization during the surgical procedure. The mean logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) significantly improved from preoperatively 2.64 (hand movement) to 1.73 (7/400), 1.50 (6/200), 1.51 (6/200), and 1.45 (7/200) at 1 month, 3 months, 6 months after the initial surgery, and final follow-up. Postoperative complications included temporary higher intraocular pressure, silicone oil emulsification, lens opacification, epimacular membrane, retinal pigment epithelium loss, and subretinal fibrosis. At the end of the follow-up, retinas were all reattached without any recurrence of choroidal neovascularization. Conclusion: Pars plana vitrectomy combined with retinotomy and silicone oil tamponade is effective for eyes with breakthrough vitreous hemorrhage and massive subretinal hemorrahge. Abstract : The article introduces the encouraging long-term outcomes of pars plana vitrectomy combined with 360° retinotomy and silicon oil tamponade in the treatment of patients with breakthrough vitreous hemorrhage and massive subretinal hemorrahge.