Related Experiment Video
Updated: Sep 22, 2025
Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases
Published on: June 14, 2021
Inverse drainage Nd:YAG membranotomy for pre-macular hemorrhage
Naresh Babu1, Piyush Kohli1, Renu P Rajan1
1Department of Vitreo-retinal Services, 29954Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
Aim:
To report the outcomes of the "inverse drainage Nd:YAG laser membranotomy" technique for the management of pre-macular hemorrhage (PMH), which has its inferior margin near the fovea.
Methods:
This retrospective study included eyes with PMH, with its inferior margin located within 0.5 disc-diameter (DD) of the fovea. Laser membranotomy was performed near the superior margin of PMH followed by intravitreal injection of 0.3 mL undiluted sulphur hexafluoride (SF6) gas. The patients were advised to maintain a prone position for three days.
Results:
Twenty patients (20 eyes) with a mean age of 46.1 ± 18.6 years were included in the study. The mean duration of symptoms was 6.9 ± 7.0 days. The mean size of PMH was 4.1 ± 1.2DD. The causes of PMH were Valsalva retinopathy (n = 11) and retinal artery macroaneurysm (RAM, n = 9). The mean maximum height of the blood collection, measured by optical coherence tomography (OCT), within 1 disc-diameter from the inferior and superior borders of the PMH was 738.9 ± 232.9μm and 1240.6 ± 338.1μm respectively (p = 0.001). The mean best-corrected visual acuity (BCVA) improved from logMAR 1.32 ± 0.44 (Snellen equivalent, 20/418) to logMAR 0.11 ± 0.20 (Snellen equivalent, 20/26) (p = 0.001). Vitrectomy was not required in any case. Persistent pre-macular cavity, macular hole, epiretinal membrane (ERM), intra-ocular pressure spike, or rhegmatogenous retinal detachment (RRD) was not noted in any patient.
Conclusion:
This technique can be safely used to treat eyes with PMH having its inferior margin near the fovea.
Insights
The inverse drainage Nd:YAG laser membranotomy technique safely and effectively treats pre-macular hemorrhage (PMH) near the fovea. This method significantly improves visual acuity and avoids the need for vitrectomy.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Diseases
Background:
- Pre-macular hemorrhage (PMH) located near the fovea presents a management challenge.
- Traditional treatments may carry risks or be less effective for fovea-involving PMH.
Purpose of the Study:
- To evaluate the outcomes of the "inverse drainage Nd:YAG laser membranotomy" technique for PMH with its inferior margin close to the fovea.
- To assess the safety and efficacy of this minimally invasive approach.
Main Methods:
- Retrospective study of 20 eyes with PMH near the fovea.
- Nd:YAG laser membranotomy performed superiorly, followed by intravitreal injection of sulfur hexafluoride (SF6) gas.
- Patients maintained a prone position for three days post-procedure.
Main Results:
- Significant improvement in best-corrected visual acuity (BCVA) from logMAR 1.32 to 0.11 (p=0.001).
- No cases required vitrectomy; no significant complications like macular hole or retinal detachment were observed.
- Optical coherence tomography (OCT) confirmed effective blood drainage.
Conclusions:
- The inverse drainage Nd:YAG laser membranotomy technique is a safe and effective treatment for PMH near the fovea.
- This approach offers a valuable alternative to vitrectomy, preserving visual function.
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:25Glaucoma: Overview