Improving vitreoretinal surgery

April 1, 2013

Treating the aetiology of recurrent vitreous haemorrhage improves patient outcomes

However, treatment options to deal with the factors associated with RVH after PPV do not address the aetiology of the problem or provide a cure. "Accordingly, there is no current consensus about the treatment of choice for these patients," added Drs Nadal and Carreras. "We believe that the results of our study could contribute to the improvement of two important factors in vitreoretinal surgery!"

"Our approach was based on direct treatment of the aetiology through eliminating the neovessels at the sclerotomy site and avoiding recurrence," said Drs Nadal and Carreras.

In eyes with sclerotomy site neovascularization, fibrovascular tissue can grow around the old incisions. This is as a result of a hypoxic response to peripheral retinal ischaemia and can favour movement of episcleral vessels through the sclerotomy site.

"Sclerotomies with incarcerated vitreous provide scaffold for ingrowing episcleral vessels eventually leading to new vessels being formed and recurrent vitreous haemorrhage occurring," they continued. "We proposed removal of any scaffold for neovascular growth by diathermy of sclerotomy site neovessels and ablation of existing retinal ischaemic tissue, which reduces hypoxic and/or angiogenic stimuli."