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Betsy Colon, Jose M. Garcia-Gonzalez, Maria H. Berrocal; Yag Laser Peripheral Capsulotomy For Persistent Vitreous Hemorrghage After Pars Plana Vitrectomy In Pseudophakic Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):985.
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© ARVO (1962-2015); The Authors (2016-present)
To assess resolution of persistent vitreous hemorrhage and visual outcomes in pseudophakic vitrectomized eyes after a neodymium: ytrium-aluminium-garnet (yag laser) peripheral capsulotomy.
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.
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%).
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.
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