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Shaun Ittiara, RIchard C. Lin, Ravi D. Patel, Seenu M. Hariprasad; Outcomes of 20, 23, and 25 Gauge Pars Plana Vitrectomy for Dense Vitreous Hemorrhage Based on Etiology and Duration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3751.
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To investigate outcomes after 20, 23, and 25 gauge pars plana vitrectomy for non-clearing vitreous hemorrhage with limited view of the posterior pole based on varying etiology and duration.
A retrospective chart review was performed for vitrectomy surgeries performed by a single surgeon (SMH) between August 2005 and October 2011 with a primary diagnosis of vitreous hemorrhage. Fifty-five eyes of 51 patients that underwent primary vitrectomy for a non-clearing vitreous hemorrhage with limited view of the posterior pole were enrolled in the study. Patients with a clear view of the posterior pole or vision better than 20/80 were excluded from the study. Duration of hemorrhage, underlying etiology, vitrectomy gauge, complications, and most recent preoperative and final postoperative visual acuity were evaluated.
The series included 41 eyes (74.5%) with proliferative diabetic retinopathy (PDR), 5 eyes (9.1%) with vascular occlusion, 2 eyes (3.6%) with sickle retinopathy, and 7 eyes with other etiologies. Overall, vision improved an average of 2.6 Snellen lines in 42 eyes (65.6%), stabilized in 12 eyes (18.8%), and deteriorated in 10 eyes (15.6%). With regard to etiology, visual outcome improved an average of 2.6 lines with PDR, 4.4 lines with vascular occlusion, and 8.5 lines with sickle retinopathy in the study population. The average duration of vitreous hemorrhage was 4.3 months. There was no statistically significant relationship between the duration of hemorrhage and visual outcome.
Pars plana vitrectomy for vitreous hemorrhage tends to have good outcomes, regardless of duration of hemorrhage or etiology. Significant cormodbid conditions such as neovascular glaucoma, traction retinal detachments, or subfoveal hemorrhages may limit visual recovery. Outcomes do not significantly differ based on vitrectomy gauge during surgery, though each gauge may offer different advantages in particular situations.
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