Surgery For Vitreous Hemorrhage Research Articles

The effect of intravitreal injection of anti-VEGF before surgery for vitreous hemorrhage

Objective To analyze the effect of intravitreal injection of anti vascular endothelial growth factor(VEGF) before surgery for vitreous hemorrhage. Methods The data of 189 eyes of 178 cases with vitreous hemorrhage from Jan.2014 to Dec.2015 were collected and analyzed retrospectively.All cases were underwent surgery and diveded into 2 groups randomly: anti-VEGF group, 81 eyes of 71 cases received anti-VEGF drug before vitrectomy; vitrectomy alone group, 108 eyes of 107 cases underwent vitrectomy only.The indicators preoperative and postoperative were recorded and analyzed. Results The iatrogenic retinal tears occurred in 3 eyes(3.7%) of anti-VEGF group and 14 eyes (13.0%) in vitrectomy alone group.The usage rate of electrocoagulation was 4.9% in anti-VEGF group and 17.6% in vitrectomy alone group. Silicone oil tamponade was receieved in 14 eyes (17.3%) of anti-VEGF group and 39 eyes (36.1%) in vitrectomy alone group.The differences were statistically significant between the two groups(P<0.05). The BCVA of improvement of≥3 lines accounted for 80.2% in anti-VEGF group and 61.1% in vitrectomy alone group respectively 6-12 months after surgery.The difference was statistically significant(P=0.004). During follow-up time the rate of photocoagulation again was 2.5% of anti-VEGF group and 11.11% in vitrectomy alone group respectively, the difference was statistically significant(P=0.017). But the rate of vitreous hemorrhage recurrence was 11.1% in anti-VEGF group and 12.1% in vitrectomy alone group respectively, the difference was not significant (P=0.844). Conclusion Intravitreal injection of anti-VEGF before operation could relieve the damage, clecrease the times of silicone oil tamponade and photocoagulation again, improve visual acuity. Key words: Vitreous hemorrhage; Vitrectomy; Anti-vascular endothelial growth factor; Visual acuities, best-corrected

Vitreoretinal Management and Surgical Outcomes in Proliferative Sickle Retinopathy: A Case Series

To report the outcomes of current vitreoretinal surgical management of proliferative sickle retinopathy and to compare current methods to previous studies. A retrospective, interventional case series. Fifteen eyes of 14 patients with proliferative sickle retinopathy were managed with vitreoretinal surgery over a 12-year period at a single institution. Nine patients had a sickle cell-hemoglobin C (SC) profile, 1 was sickle cell-beta(+) thalassemia (S beta(+)-thal), and 4 were sickle cell trait (AS). All 15 eyes underwent pars plana vitrectomy (PPV): 6 for vitreous hemorrhage (VH), 1 for epiretinal membrane (ERM), and an additional 8 for tractional retinal detachment (RD) and/or rhegmatogenous RD. In addition, an encircling scleral buckle (SB) was used in 2 cases. In 7 cases, 20 gauge PPV was used; 23 gauge was used in 3; and 25 gauge was used in 5. All 7 eyes with VH or ERM had improved vision postoperatively. Four of the 8 patients with traction and/or rhegmatogenous RD developed recurrent detachments and required a second operation. All retinas were attached at last follow-up, and visual acuity was 20/400 or better in all eyes. No cases of anterior segment ischemia were encountered. Anterior segment ischemia is no longer a common occurrence in eyes undergoing surgery for proliferative sickle retinopathy. Although PPV has replaced the use of SB in many situations, an encircling SB may still be used in this population when necessary. Surgery for VH and ERM generally results in favorable outcomes, but eyes undergoing surgery for traction/rhegmatogenous RD carry a more guarded prognosis.

Vitrektomie bei diabetischer Retinopathie: Ergebnisse, Risikofaktoren, Komplikationen

Functional results, risk factors and complications of vitrectomy for diabetic retinopathy were studied to improve our estimation for benefits and risks of vitreous surgery with current techniques. The course of 389 consecutive eyes, who had undergone vitreous surgery for complications of diabetic retinopathy within a four year period, was retrospectively reviewed. The minimum follow-up was 6 months, the median 26 months. Risk factors were studied using multivariate logistic regression analysis. Six months postoperatively 25% of the eyes had a visual acuity of 20/60 or better, a vision of less than 5/200 was found in 25% of the eyes. The most important risk factors were detachment of the macula and iris rubeosis. Only 16% of the eyes with tractional detachment of the macula had a postoperative vision of 20/200 or better, although in 86% the macula was anatomically successfully reattached. Postoperative retinal detachment was observed in 18% of all eyes. The incidence of this serious complication was only 5% after surgery for vitreous hemorrhage, but 54% after vitrectomy for tractional detachment of the macula. In eyes with advanced stages of long-standing tractional detachment of the macula, the functional prognosis is very poor due to the underlying microvascular disease. In less advanced stages with vitreous hemorrhage and flat retina the risk of vitreous surgery is low.