Displacement of Submacular Hemorrhage With Vitrectomy Combined With Subretinal Balanced Salt Solution and Air

• Published in: Retina (Philadelphia, Pa.) Vol. 43; no. 12; p. 2194
• Main Authors: Handa, Sabia, Dogra, Mohit, Tigari, Basavraj, Katoch, Deeksha, Singh, Ramandeep
• Format: Journal Article
• Language: English
• Published: United States 01.12.2023
• Subjects: Fibrinolytic Agents - therapeutic use; Humans; Injections, Intraocular; Macula Lutea; Retinal Hemorrhage - diagnosis; Retinal Hemorrhage - surgery; Retrospective Studies; Tissue Plasminogen Activator; Treatment Outcome; Vitrectomy - methods
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0000000000003879

To describe a technique of displacement of submacular hemorrhage (SMH) using subretinal injection of balanced salt solution and filtered air. Patients presenting within 2 weeks of massive SMH (>4 disk diameter) were prospectively included. All patients underwent 25-gauge pars plana vitrectomy, posterior vitreous detachment, injection of subretinal balanced salt solution and filtered air followed by partial fluid air exchange, 20% sulfur hexafluoride tamponade, and heads-up positioning postoperatively. Degree of displacement of SMH was assessed at 1 month and change in best-corrected visual acuity was assessed at 3 months. Ten patients with massive SMH who underwent the aforementioned procedure were included. Complete displacement of bleed from the macula was achieved in nine (90%) of 10 eyes at 1 month. There was significant improvement in best-corrected visual acuity from baseline at 1 month ( P = 0.015) and 3 months ( P = 0.043). Pars plana vitrectomy with injection of subretinal balanced salt solution and filtered air was well-tolerated and efficacious in displacing large and thick SMH in patients operated within 2 weeks of onset of symptoms.