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A SURGICAL APPROACH TO LARGE SUBRETINAL HEMORRHAGE USING PARS PLANA VITRECTOMY AND 360° RETINOTOMY

Wei, Yantao MD, PhD; Zhang, Zhaotian MD; Jiang, Xintong MD, PhD; Li, Fan MD; Zhang, Ting MD, PhD; Qiu, Suo MD; Yang, Yuanzhe MD; Zhang, Shaochong MD

doi: 10.1097/IAE.0000000000000501
Original Study
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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.

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: zhshaochong@outlook.com

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.

© 2015 by Ophthalmic Communications Society, Inc.