Subretinal Lavage: A Technique of Continuous Subretinal Irrigation for Removal of Traumatic Submacular Hemorrhage
作者:
Ulrich H. Steinhorst,
Marc Theischen,
Rolf Winter,
期刊:
Ophthalmologica
(Karger Available online 1997)
卷期:
Volume 211,
issue 6
页码: 399-401
ISSN:0030-3755
年代: 1997
DOI:10.1159/000310841
出版商: S. Karger AG
关键词: Trauma;Retina;Subretinal hemorrhage;Vitrectomy;Retinotomy;Tissue plasminogen activator
数据来源: Karger
摘要:
A 12-year-old female patient suffered a horse kick to her face, resulting in various orbital fractures and blunt eye trauma. Upon ophthalmoscopy, an extensive subretinal hemorrhage was revealed under the macula, reaching to both vascular arcades. The visual acuity was 20/300. Five days after the accident, the patient was referred for vitreoretinal surgery. After standard vitrectomy, a small retinotomy was made at the temporal raphe. A second infusion was directed under the retina, thereby separating it carefully from the clot. The blot clot was exposed to tissue plasminogen activator (0.012 mg/0.1 ml) for 30 min. The liquefied blood was then washed out by continuous irrigation with buffered saline solution. The procedure was terminated by gas tamponade. Eleven days after surgery, the patient’s vision had returned to 20/60. At 10 months after surgery, her vision was 20/30. No new hemorrhage was observed, nor did any fíbrovascular proliferation occur from choroidal rupture. Continuous infusion instead of use of syringes for irrigation reduces the frequency of instrument passages through the pars plana and vitreous base, which may help reduce the risk of iatrogenic ora lesions. Surgery should be performed within 7 days to avoid toxic or metabolic retinal damage.
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