ULTRASOUND-GUIDED CRYOTHERAPY FOR RETINAL TEARS IN PATIENTS WITH VITREOUS HEMORRHAGE

BACKGROUND AND OBJECTIVE: The goal was to utilize ultrasound-guided cr yotherapy as an immediate, low-risk, noninvasive, precise method of tr eating retinal tears obscured by vitreous hemorrhage. PATIENTS AND MET HODS: Eleven patients with sudden onset of vitreous hemorrhage were re ferred for diagnosis and management. Ophthalmoscopy with scleral depre ssion was unsuccessful at localizing peripheral retinal tears, and all of the patients were examined with ultrasound using the techniques of standardized echography. The cryoprobe was positioned for cryotherapy using both transverse and longitudinal B-scan approaches following th e indentation of the globe as it appeared on the oscilloscope. RESULTS : On follow-up examination after the examined by ophthalmoscopy and we re thought to have been adequately treated. One patient had a retinal detachment after remaining stable for 3 months. Two patients were trea ted with laser to enhance the cryotherapy seal. One patient was observ ed by another physician and underwent vitrectomy due to vitreous hemor rhage that persisted 2 months following cryotherapy. After vitrectomy, the physician reported a successful cryotherapy reaction at the treat ed tear. One final patient in the series required vitrectomy and scler al buckle before the hemorrhage had cleared, and the treatment did not appear to be complete. CONCLUSION: Ultrasound-guided cryotherapy prov ides a noninvasive, inexpensive treatment alternative for retinal tear s obscured by vitreous hemorrhage.