Evaluation of pulsed Nd:YAG laser posterior hyaloidotomy as an emergency treatment for blinding premacular subhyaloid hemorrhage
Hazem A Hazem1, Tarek A Shazly1,2
1Department of Ophthalmology, Assiut University Hospital, Assiut, Egypt; 2Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
Purpose: This study aimed to evaluate the benefits of Nd:YAG laser posterior hyaloidotomy as a method allowing rapid drainage of subhyaloid hemorrhage into the vitreous gel.
Design: Nonrandomized, prospective, interventional, controlled case series.
Methods: Nd:YAG laser posterior hyaloidotomy was performed in four eyes of three patients with premacular subhyaloid hemorrhage. The etiologies were bleeding tendency, proliferative diabetic retinopathy, and idiopathic. Four eyes of four patients with premacular subhyaloid hemorrhage were managed conservatively. The etiologies were proliferative diabetic retinopathy and Valsalva retinopathy.
Results: A rapid resolution of subhyaloid hemorrhage with improvement of visual acuity was achieved in all patients treated with Nd:YAG laser posterior hyaloidotomy, without evidence of damage to the retina or choroid. With regard to the conservatively managed eyes, there was a tendency towards slow spontaneous absorption of hemorrhage during the follow-up period.
Conclusion: Nd:YAG laser posterior hyaloidotomy was a safe and effective procedure for rapid resolution of premacular subhyaloid hemorrhage, allowing rapid restoration of visual acuity, visualization of the underlying retina, expedited access for macular photocoagulation and avoidance of vitrectomy.
Keywords: retinal hemorrhage, vitreous hemorrhage, laser surgery, proliferative diabetic retinopathy
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF]