Planned two-step vitrectomy for extremely large and thick subretinal hematoma

Citation
T. Matsuo et al., Planned two-step vitrectomy for extremely large and thick subretinal hematoma, ACT OPHTH S, 79(5), 2001, pp. 533-537
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Optalmology
Journal title
ACTA OPHTHALMOLOGICA SCANDINAVICA
ISSN journal
1395-3907 → ACNP
Volume
79
Issue
5
Year of publication
2001
Pages
533 - 537
Database
ISI
SICI code
1395-3907(200110)79:5<533:PTVFEL>2.0.ZU;2-G
Abstract
Purpose: To describe a new surgical strategy, planned two-step vitrectomy, for a large and thick subretinal hematoma involving 3 or more quadrants of the fundus. Surgical Methods: In a first-step vitrectomy, a retinotomy was made in the posterior pole, after any vitreous hemorrhage had been removed. Following f luid-gas exchange with no laser photocoagulation around the retinotomy, pat ients took a face-down position for a few days to a week to facilitate subr etinal hemorrhage movement to the vitreous cavity and anterior chamber. In a second-step surgery, the hemorrhage in the vitreous cavity and anterior c hamber was washed out. The remaining subretinal hemorrhage was aspirated, a nd the retina was reattached with fluid-gas exchange and laser photocoagula tion around the retinotomy. Results: The planned two-step vitrectomy was performed in 4 consecutive pat ients with large and thick subretinal hematomas involving 3 or more quadran ts seen during a 3-year period. By a face-down position after the first-ste p vitrectomy, subretinal hemorrhage moved to the vitreous cavity and anteri or chamber. The remaining subretinal hemorrhage in a smaller quantity could be easily removed, leading to retinal reattachment in the second-step surg ery. Conclusions: The planned two-step vitrectomy is a safer and more effective procedure for removing a large quantity of subretinal hemorrhage in a short er period of surgical time, compared with hemorrhage removal in a single vi trectomy.