Photodisruptive Nd:YAG Laser in the Management of Premacular Subhyaloid Hemorrhage

2001 ◽  
Vol 11 (3) ◽  
pp. 281-286 ◽  
Author(s):  
S. Çelebi ◽  
A.S. Kükner
Keyword(s):  
Visual Acuity ◽  
Laser Treatment ◽  
Nd:Yag Laser ◽  
Hand Movement ◽  
Vitreous Cavity ◽  
Rapid Improvement ◽  
Primary Vitrectomy ◽  
Benign Condition ◽  
The Mean ◽  
Subhyaloid Hemorrhage

Purpose Premacular subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because the hemorrhage may cause permanent macular changes before it resolves, Nd:YAG laser posterior hyaloidotomy may be indicated in selected cases. This study investigated the effects of drainage of premacular subhyaloid hemorrhage into the vitreous with Nd:YAG laser treatment. Methods This study was conducted between February 1996 and March 1999. Six patients had a circumscribed premacular hemorrhage in one eye and were treated with the Nd:YAG laser to drain the blood into the vitreous cavity. The hemorrhage originated from Valsalva retinopathy (2 cases), proliferative diabetic retinopathy (2 cases), central retinal vein occlusion (1 case), and blunt ocular trauma (1 case). The size of the hemorrhage is expressed in disc diameters. Results The mean pretreatment hemorrhage measured 5.7 disc diameters (range 3.5–8.0). Visual acuity in all cases before laser treatment was hand movement. After laser treatment, the hemorrhage instantly drained into the vitreous cavity, resulting in rapid improvement of vision. Drainage was complete within one week and visual acuity improved dramatically. The mean follow-up was 26.3 months (range 7–42 months). No retinal damage or rebleeding occurred due to the laser treatment, and vitrectomy was not required in any eye. Conclusions Nd:YAG laser posterior hyaloidotomy may be useful for draining a premacular hemorrhage into the vitreous cavity in selected cases. To establish this as a routine procedure, a randomized prospective study is needed to compare observation, primary vitrectomy, and Nd:YAG laser treatment.

scholarly journals Effect of Nd:Yag Laser Hyaloidotomy for Premacular Subhyaloid Haemorrhage

2015 ◽  
Vol 3 (1) ◽  
pp. 51-53
Author(s):  
Gynendra Lamichhane ◽  
Sweta Singh
Keyword(s):  
Visual Acuity ◽  
Laser Treatment ◽  
Nd:Yag Laser ◽  
Vision Loss ◽  
Vitreoretinal Surgery ◽  
Invasive Procedure ◽  
Common Condition ◽  
Medical Sciences ◽  
Non Invasive ◽  
Subhyaloid Hemorrhage

INTRODUCTION: Premacular subhyaloid hemorrhage is a common condition leading to severe sudden vision loss in various conditions.This study investigated the effects of drainage of premacular subhyaloid hemorrhage into the vitreous with Nd:YAG laser treatment. Photodisruption with Zeiss Nd.Yag laser done in the inferior part of the the hemorrhage to create hole in ILM for gravitational drainage of blood in vitreous. 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. Nd:YAG laser posterior hyaloidotomy is simple, effective, safe and non invasive procedure for draining a premacular hemorrhage into the vitreous cavity and to avoid vitreoretinal surgery and complication related to long standing macular toxicity by blood.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 51-53

scholarly journals Nd:YAG Laser Hyaloidotomy for Treatment of Subhyaloid Hemorrhage in Pregnancy

2020 ◽  
Author(s):  
Mojtaba Abrishami ◽  
Nasser Shoeibi ◽  
Hamid Reza Heidarzadeh ◽  
Ghodsieh Zamani
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Pregnant Patient ◽  
Visual Recovery ◽  
Case Presentation ◽  
Hand Motion ◽  
Valsalva Retinopathy ◽  
Eye Examination ◽  
In Pregnancy ◽  
Subhyaloid Hemorrhage

Abstract Purpose: To report a pregnant patient with impaired vision due to macular involvement of valsalva retinopathy associated with subhyaloid hemorrhage, who was effectively treated with Nd:YAG laser hyaloidotomy and led to successful visual recovery.Case presentation: A thirty-year-old pregnant woman at 36-week gestational age was referred due to suddenly decreased visual acuity in her left eye following a severe vomiting. Left eye examination showed a dense large subhyaloid hemorrhage in front of macula extending from superior to inferior arcade with a clear media. With the diagnosis of subhyaloid hemorrhage she underwent Nd:YAG laser hyaloidotomy and visual acuity improved from hand motion to 20/20 after one week.Conclusion: In this report, Nd:YAG laser hyaloidotomy was shown to be effective and safe in treatment of dense subhyaloid hemorrhage in pregnant patients with Valsalva retinopathy.

Comparison of ranibizumab and subthreshold micropulse laser in treatment of macular edema secondary to branch retinal vein occlusion

2018 ◽  
Vol 28 (6) ◽  
pp. 690-696 ◽  
Author(s):  
Yelda Buyru Özkurt ◽  
Sezen Akkaya ◽  
Sibel Aksoy ◽  
Mert Hakan Şimşek
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Treatment ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Ranibizumab ◽  
Micropulse Laser ◽  
Vein Occlusion ◽  
Subthreshold Micropulse Laser ◽  
The Mean

Purpose: To compare the effects of intravitreal ranibizumab injection and yellow (577 nm) subthreshold micropulse laser treatment in patients with macular edema following non-ischemic branch retinal vein occlusion. Methods: The medical records of 51 patients who underwent intravitreal ranibizumab (0.5 mg) injection or subthreshold micropulse laser for the treatment of macular edema due to branch retinal vein occlusion were retrospectively reviewed. Subthreshold micropulse laser was administered with a 10% duty cycle, 100 μm spot diameter, 200 ms exposure time. The patients received an injection or laser treatment at baseline and were, then, retreated as needed and were followed for 12 months. The mean best corrected visual acuity changes over the follow-up and the decrease in the mean central macular thickness were evaluated. Results: A total of 27 and 24 patients were assigned to intravitreal ranibizumab and subthreshold micropulse laser subgroups, respectively. The mean number of treatment was 3.81 of intravitreal ranibizumab group and 1.5 of subthreshold micropulse laser group (p < 0.05). The subgroups were similar with regard to the mean score of best corrected visual acuity at baseline, at 1, 6, and 12 months (p > 0.05). The decrease in the mean central macular thickness was significant in both intravitreal ranibizumab and subthreshold micropulse laser groups at 1, 6, and 12 months than that of values at baseline (p < 0.05). No new ocular or systemic adverse events were observed. Conclusion: Our study results showed that intravitreal ranibizumab or yellow subthreshold micropulse laser treatment for macular edema due to branch retinal vein occlusion was not found to be superior to each other for reducing macular thickness and increasing visual acuity for 1-year period. Based on these results, subthreshold micropulse laser may be a useful alternative approach in the treatment of macular edema secondary to branch retinal vein occlusion.

scholarly journals Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema

2015 ◽  
Vol 72 (10) ◽  
pp. 876-882 ◽  
Author(s):  
Sandra Jovanovic ◽  
Vladimir Canadanovic ◽  
Ana Sabo ◽  
Zorka Grgic ◽  
Milena Mitrovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Treatment ◽  
Diabetic Macular Edema ◽  
Combined Treatment ◽  
Intravitreal Bevacizumab ◽  
Primary Treatment ◽  
Intravitreal Bevacizumab Injection ◽  
Vegf Inhibitor ◽  
The Mean

Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema (DME) is one of the leading causes of the loss of visual acuity. The aim of this study was to determine the efficacy of the intravitreal vascular endothelial growth factor (VEGF) inhibitor application alone or combined with macular focal/grid lasephotocoagulation compared with laser treatment alone. Methods. This prospective randomized clinical trial included 72 patients (120 treated eyes) with varying degrees of DR and DME. The DME treatment included intravitreal VEGF inhibitor bevacizumab (Avastin?) application, with and without laser treatment. Bevacizumab (1.25 mg/0.05 mL) was administered intravitreally in 4-6-week intervals. Laser is applied 4-6 weeks after last dose of the drug as a part of combined treatment, or as the primary treatment. Results. The mean reduction in central macular thickness (CMT) for the eyes (n = 31) treated with bevacizumab alone was 162.23 ?m, for the eyes (n = 53) treated with combined treatment the mean reduction in CMT was 124.24 ?m, both statistically significant at p < 0.001. Laser macular photocolagulation as a part of combined treatment (in 53 eyes) significantly contributed to the CMT reduction, based on the paired t-test results (366.28 vs 323.0 ?m at p < 0.05). In our study, the mean visual acuity improvement of 0.161 logMAR was achieved in the group of eyes treated with bevacizumab alone, and 0.093 logMAR in the group with combined treatment, both statistically significant at p < 0.05. The effect of laser photocolagulation alone on visual acuity and CMT was not statistically significant. Conclusion. Treatment with bevacizumab alone or within combined treatment is more effective in treating DME than conventional macular laser treatment alone, both anatomically and functionally.

scholarly journals Nd:YAG Laser Photodisruption for Multilevel Premacular Hemorrhage due to Isolated Retinal Venous Macroaneurysm

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Kenan Sonmez ◽  
Pehmen Y. Ozcan
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Laser Treatment ◽  
Nd:Yag Laser ◽  
Blood Cells ◽  
Internal Limiting Membrane ◽  
Hand Motion ◽  
First Case ◽  
The Right

A 55-year-old man presented with sudden deterioration of vision in the right eye. His visual acuity was reduced to hand motion because of a large multilevel premacular hemorrhage. Nd:YAG laser was performed to drain the entrapped hemorrhage under the internal limiting membrane (ILM) and posterior hyaloid face in the macula into the vitreous. Immediately after laser treatment, streaming of red blood cells into the vitreous gel through the perforation site was observed. At the first-month follow-up, BCVA improved to 20/25 and ILM wrinkling was observed at the macula where the preretinal hemorrhage cleared. Fluorescein angiography revealed an isolated retinal venous macroaneurysm located on the macular branch of the superotemporal vein at the bifurcation site. In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare. To the best of our knowledge, this is the first case reported with multilevel premacular hemorrhage caused by an isolated retinal venous macroaneurysm.

scholarly journals Revision Surgery for Idiopathic Macular Hole after Failed Primary Vitrectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Alexandre Lachance ◽  
Eunice You ◽  
Jérôme Garneau ◽  
Serge Bourgault ◽  
Mathieu Caissie ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Revision Surgery ◽  
Primary Outcome ◽  
Initial Presentation ◽  
Idiopathic Macular Hole ◽  
Primary Vitrectomy ◽  
Primary Surgery ◽  
Corrected Visual Acuity ◽  
The Mean

Purpose. To investigate the anatomical and functional outcomes of revision surgery after failed primary surgery for idiopathic macular hole (MH). Methods. All consecutive patients with MH were identified from a cohort of patients operated between 2014 and 2018 at the CHU de Québec-Université Laval (Québec). The clinical and anatomical features of patients with unclosed MH after primary surgery were retrospectively collected. Our primary outcome was MH nonclosure rate after revision surgery. Our secondary outcomes were best-corrected visual acuity (BCVA) with ETDRS scale and MH size of eyes with revision surgery preoperatively and at 3 and 12 months after revision surgery. Results. In our cohort of 1085 eyes, 926 eyes met inclusion criteria and were analyzed in the study. We identified 22 eyes with failed primary surgery (2.4%), of which 20 underwent revision surgery. We had no bilateral MH in these 22 eyes. The nonclosure rate of MH after revision surgery was 15%. The mean final BCVA for closed MH after revision surgery was 55 ± 19 letters. Compared to the initial presentation, the mean change in visual acuity (VA) for closed MH was +4 ± 31 letters and +16 ± 17 letters at 3 and 12 months after the revision surgery, respectively. At initial presentation, patients with failed primary surgery had a baseline MH size of 665 ± 226 μm. The mean MH size after failed primary surgery was 607 ± 162 μm and 546 ± 156 μm for the three unclosed MHs one month after revision surgery. Conclusion. The success rate of revision surgery in eyes with unclosed MH is 85%. After successful revision surgery, eyes demonstrated an improvement in VA and closure of the MH.

One-year real-life results on effect of intravitreal aflibercept in patients with diabetic macular oedema switched from ranibizumab

2020 ◽  
pp. 112067212092727
Author(s):  
Marko Lukic ◽  
Gwyn Williams ◽  
Zaid Shalchi ◽  
Praveen J Patel ◽  
Philip G Hykin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Early Treatment ◽  
Macular Oedema ◽  
Real Life ◽  
Diabetic Macular Oedema ◽  
Foveal Thickness ◽  
Macular Volume ◽  
Central Foveal Thickness ◽  
The Mean

Purpose To assess visual and optical coherence tomography–derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®). Design Retrospective, cohort study. Participants Ninety eyes (of 67 patients) receiving intravitreal anti–vascular endothelial growth factor therapy were included. Methods This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given. Main Outcome Measures We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given. Results Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was −1.53 mm 3 in SW group (p = 0.21), while the change in central foveal thickness was −136.8 μm (p = 0.69). Conclusion There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

scholarly journals 27-gauge trocar-assisted sutureless intraocular lens fixation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Jujo ◽  
Jiro Kogo ◽  
Hiroki Sasaki ◽  
Reio Sekine ◽  
Keiji Sato ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Intraocular Lens ◽  
Vitreous Hemorrhage ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Corneal Endothelial Cell Density ◽  
The Mean ◽  
Iol Fixation

Abstract Backgrounds However there have been numerous investigations of intrascleral intraocular lens (IOL) fixation techniques, there is room for improvement in terms of simplifying complicated techniques and reducing the high levels of skill required. This study aimed to report a novel technique for sutureless intrascleral fixation of the IOL using retinal forceps with a 27-gauge trocar. Methods Nineteen eyes of 18 patients underwent intrascleral fixation of the IOL from July 2018 to September 2019 were enrolled in this study. A 27-gauge trocar formed 3-mm scleral tunnels positioned at 4 and 10 o’clock, 2 mm from the corneal limbus. We used a 3-piece IOL haptic grasped by a 27-gauge retinal forceps and pulled from the 27-gauge trocar. The IOL was fixed by making a flange. Main outcome measures were visual acuity, corneal endothelial cell density, IOL tilt, decentration, predicted error of refraction and complications. Results The 19 eyes were followed up for 1 month. The mean pre- and postoperative logMAR uncorrected visual acuity (UCVA) was 1.06 ± 0.63 and 0.40 ± 0.26, respectively (p < 0.01), while the mean pre- and postoperative logMAR best corrected visual acuity (BCVA) was 0.27 ± 0.51 and 0.06 ± 0.15, respectively (p = 0.09). The mean corneal endothelial cell density was 2406 ± 625 to 2004 ± 759 cells/mm2 at 1 month (p = 0.13). The mean IOL tilt was 3.52 ± 3.00°, and the mean IOL decentration was 0.39 ± 0.39 mm. There was no correlation among IOL tilt, decentration and BCVA (p > 0.05). The mean prediction error of the target refraction was − 0.03 ± 0.93 D. The complications were vitreous hemorrhage (3 eyes), hyphema (1 eye), IOP elevation (1 eye), iris capture of the IOL (1 eye) and hypotony (2 eyes). No IOL dislocation occurred. Conclusions IOL intrascleral fixation with a flange achieved good IOL fixation and visual outcome in the scleral tunnels created with the 27-gauge trocar.

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