Ali Said Yasmin, Dewilde Evelien, Stalmans Peter
Department of Ophthalmology, UZ Leuven, Herestraat 49, Leuven 3000, Belgium.
J Ophthalmol. 2021 Dec 30;2021:3160963. doi: 10.1155/2021/3160963. eCollection 2021.
To determine the efficacy and safety of 23G transconjunctival sutureless vitrectomy, subretinal injection of tissue plasminogen activator using the EVA Surgical System, and pneumatic displacement with air to treat submacular hemorrhages.
Retrospective analysis of 93 eyes surgically treated for submacular hemorrhage caused by neovascular AMD or retinal macroaneurysms. . Postoperative visual acuity and surgical complications.
After surgery, visual acuity improved after 6 weeks but decreased again at the final postoperative visit at 8 months due to progression of the underlying disease. Complications consisted of 2 cases of retinal pigment epithelial tear, 7 vitreous hemorrhages, 4 hyphema, 6 cases of retinal detachment, and 2 subchoroidal hemorrhages during the follow-up period.
This study suggests that a surgical approach with 23G vitrectomy, subretinal tPA injection, and pneumatic displacement using air may be an effective procedure for submacular hemorrhage displacement in patients with AMD and retinal macroaneurysms. However, visual outcome is limited by the underlying macular pathology. Larger multicenter randomized controlled studies are warranted to determine the therapeutic effect of this surgical approach.
确定使用EVA手术系统进行23G经结膜无缝线玻璃体切除术、视网膜下注射组织纤溶酶原激活剂以及空气气驱置换治疗黄斑下出血的疗效和安全性。
回顾性分析93只因新生血管性年龄相关性黄斑变性或视网膜大动脉瘤导致黄斑下出血而接受手术治疗的眼睛。术后视力及手术并发症。
术后6周视力改善，但由于基础疾病进展，在术后8个月的最后一次随访时视力再次下降。随访期间并发症包括2例视网膜色素上皮撕裂、7例玻璃体积血、4例前房积血、6例视网膜脱离和2例脉络膜下出血。
本研究表明，采用23G玻璃体切除术、视网膜下注射tPA以及空气气驱置换的手术方法可能是治疗年龄相关性黄斑变性和视网膜大动脉瘤患者黄斑下出血移位的有效方法。然而，视力结果受潜在黄斑病变的限制。需要进行更大规模的多中心随机对照研究来确定这种手术方法的治疗效果。
