Histopathology after vitrectomy with the vitrophage

Area of Science:

• Ophthalmology
• Vitreoretinal Surgery
• Diabetic Retinopathy

Background:

• Persistent vitreous hemorrhage can significantly impair vision.
• Diabetic retinopathy is a common cause of vitreous hemorrhage.
• Vitrectomy is a surgical procedure to remove vitreous humor.

Purpose of the Study:

• To describe a case of vitreous hemorrhage treated with vitrectomy.
• To analyze postoperative complications including hyphema and elevated intraocular pressure.
• To investigate the potential causes of complications and patient outcome.

Main Methods:

• A 72-year-old female patient with adult-onset diabetes underwent vitrectomy using a vitrophage for vitreous hemorrhage.
• Postoperative management included medical therapy for hyphema and elevated intraocular pressure.
• Vitreous lavage was performed to manage refractory intraocular pressure.
• Histological examination of the surgical site was conducted.

Main Results:

• The patient developed hyphema and elevated intraocular pressure refractory to medical treatment post-vitrectomy.
• Vitreous lavage successfully controlled intraocular pressure.
• Histology revealed vitreous condensation at the sclerotomy site.
• Rubeosis iridis was suspected as the cause of hyphema, and a hemolytic mechanism for elevated intraocular pressure was proposed.
• The patient died from pulmonary embolism 11 days after vitreous lavage.

Conclusions:

• Vitrectomy for vitreous hemorrhage can be associated with serious postoperative complications.
• Rubeosis iridis and hemolytic mechanisms may contribute to hyphema and elevated intraocular pressure after vitrectomy.
• Close monitoring and prompt management of complications are crucial in patients undergoing vitrectomy.
• Pulmonary embolism is a potential, albeit rare, fatal complication following vitreoretinal surgery.