M. Kamei et al., SURGICAL REMOVAL OF SUBMACULAR HEMORRHAGE USING TISSUE-PLASMINOGEN ACTIVATOR AND PERFLUOROCARBON LIQUID, American journal of ophthalmology, 121(3), 1996, pp. 267-275
PURPOSE: To assess the result of surgical removal of submacular hemorr
hage by using tissue plasminogen activator and perfluorocarbon liquid.
METHODS: In 22 consecutive patients (22 eyes), subretinal hemorrhage
associated with age-related macular degeneration, which involved the f
ovea and completely obscured the choroidal vascular pattern, was treat
ed by pars plana vitrectomy. The hemorrhages were liquefied with tissu
e plasminogen activator, squeezed into the vitreous cavity with perflu
orocarbon liquid, and then evacuated. RESULTS: Efficacy of the procedu
re was judged by the best postoperative corrected visual acuity, which
was 20/100 or better in 16 eyes (73%), Submacular hemorrhage recurred
in four (18%) eyes, epiretinal membrane formed in three (14%) eyes, a
nd retinal detachment occurred in three (5%) eyes. Best corrected fina
l visual acuity was improved postoperatively in 18 (82%) of the 22 eye
s, unchanged in three (14 %) eyes, and decreased in one (5%) eye. Fina
l visual acuity was 20/200 or better in 15 eyes (68%) and limited in o
ther eyes by subretinal hemorrhage of greater than 30 days' duration o
r subfoveal neovascularizations.CONCLUSIONS: Use of tissue plasminogen
activator and perfluorocarbon liquid in surgical removal of submacula
r hemorrhage may improve the outcome of surgery by reducing surgically
induced retinal damage.