Role of residual vitreous cortex removal in prevention of postoperative vitreous hemorrhage in diabetic vitrectomy

Cheema, Rizwan A.; Mushtaq, Javed; Cheema, Maheera A.

doi:10.1007/s10792-009-9298-7

Cited by 9 publications

(9 citation statements)

References 16 publications

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“…Cryotherapy of the sclerostomy site and peripheral retina may inhibit this neovascularization, thus preventing postoperative VCH 17,21 . Other measures, such as the use of long acting gas tamponade 22 and complete vitrectomy with removal of residual vitreous cortex 23 have been advocated to reduce the incidence of early VCH. However, despite these measures, many patients still experience VCH after diabetic vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents

Fabinyi¹,

O'Neill²,

Connell³

et al. 2011

Clinical &Amp; Experimental Ophthalmology

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Perioperative continuation of anticoagulation or antiplatelet treatment appears to increase the risk of persistent postoperative vitreous cavity haemorrhage and the necessity for vitreous cavity washout in this diabetic cohort. Appropriate preoperative cessation of treatment appeared to reduce this risk; however, caution must be taken with regard to the systemic risk associated with cessation of therapy.

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Section: Discussionmentioning

confidence: 99%

Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents

Fabinyi¹,

O'Neill²,

Connell³

et al. 2011

Clinical &Amp; Experimental Ophthalmology

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“…A small retrospective study did not find gas tamponade to be associated with a reduced rate of post-operative bleeding. 56 However, in a prospective, randomized controlled study of 61 eyes comparing eyes with intraocular gas tamponade with those without, while there was no difference in the mean time to initial clearing of VH in the two groups or the proportion of eyes that required over 5 weeks to clear their VH, there was a significant difference between rate of early recurrent VH in the two groups. Specifically, none of 31 eyes (0%) in the group that received 10% perfluropropane gas had an early recurrent VH compared to 5 of 30 (16%) in the group that did not receive intraocular gas tamponade.…”

Section: Complications After Vitrectomy For Vhmentioning

confidence: 94%

“…40, 55, 56–62 Vitreous cavity hemorrhage following PPV can be present from the first post-operative day (persistent- 20–63% of patients), or can occur within the first 4–6 weeks (early-5%) or thereafter (delayed- 8%). 40.…”

Section: Complications After Vitrectomy For Vhmentioning

confidence: 99%

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Current Management of Vitreous Hemorrhage Due to Proliferative Diabetic Retinopathy

Annan

Carvounis

2014

International Ophthalmology Clinics

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Diabetic vitreous hemorrhage secondary to proliferative diabetic retinopathy is a cause of severe vision loss in diabetic patients. Laser photocoagulation remains the primary treatment when the view allows. Intravitreous anti-VEGF injections do not appear to have a role as primary treatment but may have an invaluable role as adjuvant to surgery. Pars plana vitrectomy with endolaser panretinal photocoagulation remains the procedure of choice for non-clearing vitreous hemorrhage. The vast majority of patients with vision of 5/200 or less due to diabetic vitreous hemorrhage do not clear spontaneously even after 1 year. With improvements in surgical techniques leading to better outcomes, fewer complications, less discomfort and a faster recovery time it is reasonable to operate on such patients sooner than the 3–4 months that had been generally accepted in the past, if there has been no significant spontaneous improvement.

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“…Nonclearing vitreous hemorrhage is the major reason for a post vitrectomy vitreous cavity fluid/fluid exchange or fluid/air exchange operation. The rate of vitreous hemorrhage post PPV has been reported to be between 7 and 63% [1,2,[14][15][16][17][18][19], with 9.7% of patients requiring another surgery [12]. Some surgeons may perform PPV when there is rehemorrhage in vitreous of PDR patients post vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

Visual outcomes and complications following one-way air-fluid exchange technique for vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy patients

Wang

Zhao

et al. 2021

BMC Ophthalmol

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Background To evaluate the efficacy and outcomes of one-way surgical technique for the treatment of vitreous hemorrhage post vitrectomy on proliferative diabetic retinopathy (PDR) patients. Methods This retrospective case series include 47 PDR patients who had vitrectomy with balanced saline solution tamponade and have developed vitreous hemorrhage without significant absorption. The one-way air-fluid exchange procedure which involves the application of a 0.22-μm pore size filter to exchange about 4.5–5.5 ml of fluid with a 10 ml syringe was performed on 47 patients (47 eyes). Post procedure, additional treatments were administered when needed. Best corrected visual acuity (BCVA), occurrence of intra-procedural and post-procedural complications were recorded and analyzed. Results A total of 47 eyes of 47 PDR patients with a mean age of 50.8 ± 12.0 years were reviewed. Because of vitreous hemorrhage or tractional retinal detachment of PDR, all 47 eyes underwent vitrectomy with balanced saline solution tamponade prior to the exchange procedure. Four patients (8.51%) and 43 patients (91.5%) were diagnosed with type 1 diabetes mellitus (T1DM), or type 2 diabetes mellitus (T2DM), respectively. All 47 eyes were given the one-way air-fluid exchange procedure in the treatment room. Forty-two cases (89.4%) needed the air-fluid exchange procedure only once, 4 cases (8.51%) underwent the procedure twice, and 1 case (2.13%) was given the procedure three times, followed by additional retinal photocoagulation and one intravitreal injection of Conbercept. In addition to the procedure, no further treatment was needed for 5 eyes (10.6%) while additional retinal laser treatment was provided for 41 eyes (87.2%). The BCVA at the final follow-up was significantly improved from the initial acuity baseline in all cases. No complications were observed during the follow-ups. Conclusion This one-way air-fluid exchange procedure can effectively exchange the vitreous hemorrhage and improve visual acuity of PDR patients who develop vitreous rehemorrhage post vitrectomy without obvious complications.

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Role of residual vitreous cortex removal in prevention of postoperative vitreous hemorrhage in diabetic vitrectomy

Cited by 9 publications

References 16 publications

Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents

Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents

Current Management of Vitreous Hemorrhage Due to Proliferative Diabetic Retinopathy

Visual outcomes and complications following one-way air-fluid exchange technique for vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy patients

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