| |
DOG Congress Home
Invitation
Organization, Deadlines
Overview of the Congress
Scientific Programme
Opening Ceremony
Ceremony 150 Years of DOG
Thursday, 20.September
Friday, 21.September
Saturday, 22.September
Sunday, 23.September
Poster Sessions
Symposia
Courses
Satellite Programme
Information
Social Programme
Sponsors, Exhibitors
DOG Homepage
|
|
AbstractSO.07.08 Subretinal bleeding - take it or leave it? Schroeder F. M., Schmidt J. C., Mennel S.
Department of Ophthalmology, Philipps University, Marburg Objective: In acute massive subretinal hemorrhages in elderly patients it must be discussed, whether a pars plana vitrectomy with retinotomy and an extensive subretinal lavage is an alternative treatment option to an intravitreal rTPA and gas injection.
Methods: During the last 5 years we treated 10 patients aged 68-88 years (x=76 years) because of a massive subretinal hemorrhage. In all cases we performed a pars plana vitrectomy with a retinotomy and a subretinal lavage. Nine eyes were pseudophakic with an IOL implanted into the capsular bag, one was phakic. The bleeding was 15 days old on average (6-26 days). Four patients were on systemic anticoagulation with Marcumar®. Preoperative visual acuity was between hand movements and 0.05. All eyes received a silicone oil tamponade for 8-36 weeks. A photodocumentation was performed pre- and postoperatively.
Results: In all cases, the blood and mostly a large CNV were removed via a retinotomy following a complete vitrectomy with cleaning of the vitreous base. The silicone oil tamponade itself was a visual improvement for most patients with an oculus ultimus situation following the correction of the refraction of +4 to +7 diopters. In nine eyes, silicone oil could be removed thus far. In these eyes we found a postoperative visual acuity of 0.02 to 0.05 with a refraction of -2,0 to +1,0 diopters. Visual field could be improved in some and preserved in all eyes.
Conclusions: In eyes with massive subretinal hemorrhages, ambulatory vision can be achieved by successful pars plana vitrectomy with subretinal surgery. In patients with an oculus ultimus situation this is important to preserve their quality of life. The resulting large pigment epithelial defect limits visual rehabilitation. For the same reason, macular rotation is not possible in these cases either.
|
|
