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Sulaiman Alhumaid, Michael Kapusta; The Frequency of Postoperative Vitreous Hemorrhage in Eyes Treated with Pars Plana Vitrectomy for Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5121.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal vein occlusion (RVO) is the second most common retinal vascular disorder after diabetic retinopathy. RVOs are divided into central (CRVO), hemi-retinal (HRVO), and branch retinal vein occlusions (BRVO). Vitrectomy, a common surgical modality used to treat RVO, can potentially cause vitreous hemorrhage (VH). The frequency of VH following RVO vitrectomy has not been well established. We aim to evaluate the frequency of postoperative vitreous hemorrhage (VH) in eyes that have been treated with primary pars plana vitrectomy (PPV) for nonclearing VH resulting from RVO.
Medical records of all patients who underwent vitrectomy for RVO at a McGill university affiliated hospital, between January 2011 and December 2013, were reviewed. The collected data included: age, gender, type of RVO, lens status, previous photocoagulation, use of IntraVitreous bevacizumab (IVB), postoperative Intra-Ocular Pressure (IOP), presence of postoperative VH, time and management of VH. The history of anticoagulant/antiplateletes use was also noted.
33 cases were studied including 15 CRVO (46%), 13 BRVO (39%), and 5 HRVO (15%). The mean age was 68 (range 20-86). Male:Female is 2.3:1. The average time of follow-up is 24 months. The postoperative IOP was above 7 in all cases. Post-vitrectomy VH was found in 15 cases (46%): 7 CRVO, 5 BRVO, and 3 HRVO. Eight cases (50%) of post-vitrectomy VH occurred within a day of the procedure, six (37.5%) occurred within 1-20 weeks postoperatively, while 2 cases (12.5%) happened a year after the vitrectomy. Majority of the VH (12/16) were treated with observation, 2 cases were managed with gas-fluid exchange, and PPV was performed to treat the two VH that occurred a year later. Analysis of potential risk factors (gender, lens status, use of anticoagulant/antiplatelet, previous photocoagulation and IVB) did not show a statistically significant difference between the VH and non-VH cases (P=.28, .44, .48, 1.0, .73, respectively).
Vitreous hemorrhage following Vitrectomy done for RVO is a common complication seen in 46% of the cases, particularly in the first 24 hours after the procedure. Majority of the cases are managed with observation. No significant association was observed between the development of VH in eyes treated with vitrectomy done for RVO, and the use of previous photocoagulation, IVB or anticoagulants/antiplatelet.
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