Skip to main content

Advertisement

Log in

Management of postvitrectomy diabetic vitreous hemorrhage with volume homeostatic fluid-fluid exchanger

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To evaluate the clinical outcome of patients with postvitrectomy diabetic vitreous hemorrhage (PDVH) who underwent vitreous cavity lavage (VL) by volume homeostatic fluid–fluid exchange.

Methods

We performed a retrospective chart review for 88 eyes of 80 consecutive patients who underwent VL for PDVH. Final best-corrected visual acuity after VL was compared to those before VL. Anatomic outcome, including rate of fundus clear-up, recurrent vitreous hemorrhage, increased intraocular pressure, iris neovacularization and anterior hyaloid fibrovascular proliferation were considered.

Results

Between July 1999 and January 2006, 88 eyes of 80 patients underwent this procedure. Significant visual improvement was observed after VL (2.86 ± 0.40 logMAR at baseline vs 1.71 ± 0.97 logMAR at last visit, p < 0.0001). The fundus clear-up rate after VL was achieved in 84 out of 109 times (77.1%). Recurrent vitreous hemorrhage was found in 17 of 88 eyes (19.3%) with the mean interval of 92.6 ± 126.7 days after VL.

Conclusions

For patients suffering from postvitrectomy diabetic vitreous hemorrhage, volume homeostatic vitreous cavity lavage can be an alternative method for removing the bloody content in the vitreous cavity efficiently and permitting rapid visual recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Novak MA, Rice TA, Michaels RG, Auer C (1984) Vitreous hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmology 91:1485–1489

    PubMed  CAS  Google Scholar 

  2. Tolentino FI, Cajita VN, Gancayco T, Skates S (1989) Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy. Ophthalmology 96:1495–1500

    PubMed  CAS  Google Scholar 

  3. Yang CM, Yeh PT, Yang CH (2007) Intravitreal long-Acting Gas in the prevention of early postoperative vitreous hemorrhage in diabetic vitrectomy. Ophthalmology 114:710–715, doi:10.1016/j.ophtha.2006.07.047

    Article  PubMed  Google Scholar 

  4. Yang CM, Yeh PT, Yang CH, Chen MS (2008) Bevacizumab pretreatment and long-acting gas infusion on vitreous clear-up after diabetic vitrectomy. Am J Ophthalmol 146:211–217, doi:10.1016/j.ajo.2008.04.028

    Article  PubMed  CAS  Google Scholar 

  5. Schachat AP, Oyakawa RT, Michels RG, Rice TA (1983) Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications. Ophthalmology 90:522–529

    PubMed  CAS  Google Scholar 

  6. Blankenship GW (1986) Management of vitreous cavity hemorrhage following pars plana vitrectomy for diabetic retinopathy. Ophthalmology 93:39–44

    PubMed  CAS  Google Scholar 

  7. Campochiaro PA, Glaser BM (1985) Platelet-derived growth factor is chemotactic for human retinal pigment epithelial cell. Arch Ophthalmol 103:576–579

    PubMed  CAS  Google Scholar 

  8. Campochiaro PA, Jerdan JA, Glaser BM (1984) Serum contains chemoattractants for human retinal pigment epithelial cells. Arch Ophthalmol 102:1830–1833

    PubMed  CAS  Google Scholar 

  9. Martin DF, McCuen BM II (1992) Efficacy of fluid-air exchange for postvitrectomy diabetic vitreous hemorrhage. Am J Ophthalmol 114:457–463

    PubMed  CAS  Google Scholar 

  10. Landers MB III, Robinson D, Olsen RR, Rinkoff J (1985) Slit-lamp fluid-gas exchange and other office procedures following vitreoretinal surgery. Arch Ophthalmol 103:967–972

    PubMed  Google Scholar 

  11. Williams DF, Peter MA, Abrams GW, Han DP, Mieler WF (1990) A two-stage technique for intraoperative fluid-gas exchange following pars plana vitrectomy. Arch Ophthalmol 108:1484–1486

    PubMed  CAS  Google Scholar 

  12. Han DP, Murphy ML, Mieler WF, Abrams GW (1991) Outpatient fluid-air exchange for severe postvitrectomy diabetic vitreous hemorrhage: Long-term results and complications. Retina 11:309–314, doi:10.1097/00006982-199111030-00007

    Article  PubMed  CAS  Google Scholar 

  13. Chen JY, Wu WC, Chen MT, Wang HZ (1997) Balanced fluid exchange by volume hemeostatic fluid-fluid exchanger—a new solution to postvitrectomy vitreous hemorrhage. Kaohsiung J Med Sci 13:700–703

    PubMed  CAS  Google Scholar 

  14. Johnson RN, Olsen KR, William GA (1989) Intravitreal tissue plasminogen activator treatment of experimental vitreous hemorrhage. Arch Ophthalmol 107:891–894

    PubMed  CAS  Google Scholar 

  15. Wu WC, Chang SM, Chen JU, Chang CW (2001) Management of postvitrectomy diabetic vitreous hemorrhage with tissue plasminogen activator (t-PA) and volume homeostatic fluid-fluid exchanger. J Ocul Pharmacol Ther 17:363–371, doi:10.1089/108076801753162771

    Article  PubMed  CAS  Google Scholar 

  16. Peyman GA, Schulman JA (1986) Intravitreal surgery. Principles and practice. Appleton-Century-Croft, Norwalk, pp 389–390

    Google Scholar 

  17. Joondeph BC, Blankenship GW (1989) Hemostatic effects of air versus fluid in diabetic vitrectomy. Ophthalmology 96:1701–1706

    PubMed  CAS  Google Scholar 

  18. Koutsandrea CN, Apostolopoulos MN, Chatzoulis DZ, Parikakis EA, Theodossiadis GP (2001) Hemostatic effects of SF6 after diabetic vitrectomy for vitreous hemorrhage. Acta Ophthalmol Scand 79:34–38, doi:10.1034/j.1600-0420.2001.079001034.x

    Article  PubMed  CAS  Google Scholar 

  19. Jaffe GJ, Abram GW, William GW, Han DP (1990) Tissue plasminogen activator for postvitrectomy fibrin formation. Ophthalmology 97:184–189

    PubMed  CAS  Google Scholar 

  20. Synder RW, Lambrou FH, William GA (1987) Intraocular firbinnolysis with recombinant human tissue plasminogen activator. Arch Ophthalmol 105:1277–1280

    Google Scholar 

  21. Johnson RN, Olsen KR, Hernades E (1989) Intravitreal tissue plasminogen activator treatment of experimental vitreous hemorrhage. Arch Ophthalmol 107:891–894

    PubMed  CAS  Google Scholar 

  22. Lewis H (1994) Intraocular fibrinolysis of submacular hemorrhage with tissue plasminogen activator and surgical drainage. Am J Ophthalmol 118:559–568

    PubMed  CAS  Google Scholar 

  23. Peyman GA, Nelson NC Jr, Alturki W (1991) Tissue plasminogen activator factor assisted removal of subretinal hemorrhage. Ophthalmic Surg 22:575–582

    PubMed  CAS  Google Scholar 

  24. Kamei M, Tano Y, Ikuo Y, Ikuno Y, Mitsuda H, Yuasa T (1996) Surgical removal of submacular hemorrhage using tissue plasminogen activator and perfluorocarbon liquid. Am J Ophthalmol 121:267–275

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No potential conflict or commercial interest for this article is reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yo-Chen Chang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wu, WC., Chen, JY., Chen, YC. et al. Management of postvitrectomy diabetic vitreous hemorrhage with volume homeostatic fluid-fluid exchanger. Graefes Arch Clin Exp Ophthalmol 247, 1183–1189 (2009). https://doi.org/10.1007/s00417-009-1097-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-009-1097-3

Keywords

Navigation