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Early vitrectomy for vitreous hemorrhage associated with retinal tears
H Stevie Tan1, Marco Mura, Heico M Bijl
1Department of Ophthalmology, Academic Medical Center, University of Amsterdam, The Netherlands. h.tan@amc.uva.nl
Purpose:
To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears.
Design:
Retrospective, noncomparative interventional case series.
Methods:
We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main outcome measures were incidence of tears identified preoperatively and intraoperatively, visual acuity, and complications.
Results:
Vitrectomy took place after a mean delay of 2.7 days after presentation. A total of 69 tears were found in 40 eyes; 53.7% of tears were identified preoperatively by funduscopy or ultrasound (U/S) and the remaining 46.3% of tears were only identified during vitrectomy. Visual acuity improved significantly from 1/60 to 0.8. The sensitivity of U/S tear detection was 55.9%. A history of predisposing factors was not related to the risk of presence of unsupported tears. In 2 cases a retinal detachment developed between the U/S evaluation and vitrectomy. Postoperative complications were cataract (30%), macular pucker (2.5%), and retinal detachment (5.0%).
Conclusions:
Our findings illustrate the potential dangers of a conservative approach to vitreous hemorrhage and show that early vitrectomy has good outcome with acceptable complication rates. Prospective studies on optimal treatment of vitreous hemorrhage associated with tears are needed.
