Abstract
Purpose: :
To assess resolution of persistent vitreous hemorrhage and visual outcomes in pseudophakic vitrectomized eyes after a neodymium: ytrium-aluminium-garnet (yag laser) peripheral capsulotomy.
Methods: :
Retrospective, non-randomized study of 27 pseudophakic vitrectomized eyes with PDR and persistent or recurrent non-clearing vitreous hemorrhage treated with yag laser peripheral capsulotomy. Patients were evaluated monthly for 6 months by SLE and indirect ophthalmoscopy. Best-Corrected EDTRS visual acuity was assessed as well as IOP and degree of vitreous hemorrage present. Complications and ancillary procedures were recorded.
Results: :
Twenty one eyes of 27 achieved vitreous hemorrhage clearing with yag capsulotomy (77%). Mean time for yag laser capsulotomy after vitrectomy was 88.6 days (range 15-270 days). Mean time for VH clearance after capsulotomy was 59.6 days (range 5-240 days).A statistically significant VA improvement (p= 0.0004) was noticed 1 month after yag laser capsulotomy with an average logMAR VA of 0.404 compared to baseline. However, a greater statistically significant (p < 0.0001) VA improvement was noted at 3 months after therapy with an average logMAR va of 0.577. The visual acuity improvement was noted throughout the followup preriod of 6 months, with an average logMAR VA of 0.592 (p < 0.0001).The most common complications included increased IOP in 6 of 27 eyes (22%) and recurrent vitreous hemorrhage in 6 eyes (22%).
Conclusions: :
Peripheral yag laser capsulotomy appears to be a safe and effective management procedure for treating persistent or recurrent vitreous hemorrgage in pseudophakic vitrectomized eyes of diabetic patients. Resolution of the vitreous hemorrhage was achieved as early as 5 days post-yag, with maximum visual acuity improvement seen at 3 months. The most common complication after yag laser was transient increase in intra ocular pressure. Further studies on the benefits of this treatment modality are warranted.
Keywords: diabetic retinopathy • vitreous