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.
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.
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.
Pars plana vitrectomy combined with retinotomy and silicone oil tamponade is effective for eyes with breakthrough vitreous hemorrhage and massive subretinal hemorrahge.
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.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Reprint requests: Shaochong Zhang, MD, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54S Xianlie Road, Guangzhou 510060, China; e-mail: firstname.lastname@example.org
Part of this study was supported by a grant from the Innovation Foundation of State Key Laboratory of Ophthalmology (2011C04), a grant from National Natural Science Foundation of China (81170866), and a grant from Provincial Natural Science Foundation of Guangdong (S2011010004979).
None of the authors have any conflicting interests to disclose.
Y. Wei and Z. Zhang contributed equally to the article.