Mw. Ulbig et al., LONG-TERM RESULTS AFTER DRAINAGE OF PREMACULAR SUBHYALOID HEMORRHAGE INTO THE VITREOUS WITH A PULSED ND-YAG LASER, Archives of ophthalmology, 116(11), 1998, pp. 1465-1469
Objective: To investigate the effects of drainage of premacular subhya
loid hemorrhage into the vitreous with an Nd.YAG laser in a large seri
es of patients with longterm follow-up. Methods: A retrospective revie
w was conducted on 21 eyes with a circumscribed premacular subhyaloid
hemorrhage of various causes. These eyes were treated with a pulsed Nd
:YAG laser to drain the entrapped blood into the vitreous. The period
of review ranged from 12 to 32 months (mean, 22 months). Results: In 1
6 eyes, visual acuity improved within 1 month. Four eyes had persisten
t, dense, nonclearing vitreous opacity for at least 3 months and final
ly required vitrectomy. One clotted hemorrhage did not drain into the
vitreous. Final visual outcome was determined by the underlying diagno
sis, such as Valsalva retinopathy (7 eyes), diabetic retinopathy (7 ey
es), branch retinal vein occlusion (4 eyes), and retinal macroaneurysm
, Terson syndrome, or blood dyscrasia (1 eye each). Eyes with Valsalva
retinopathy fared the best. Complications included a macular hole in
1 eye and a retinal detachment from a retinal break in a myopic patien
t. Conclusions: Drainage of premacular subhyaloid hemorrhage into the
vitreous with an Nd:YAG laser is a viable treatment alternative for ey
es with recent bleeding. However, a macular hole and a retinal detachm
ent were observed as complications. Thus, to establish Nd:YAG laser tr
eatment as a routine procedure, the risks and benefits have to be weig
hed in a randomized trial and compared with those of deferral of treat
ment or primary vitrectomy.