Clinical study of 25G micro-incision vitrectomy on vitreous hemorrhage

AIM: To investigate the safety and effectiveness of 25G micro-incision vitrectomy on vitreous hemorrhage. METHODS: A retrospective review of 200 patients (208 eyes) who were diagnosed as vitreous hemorrhage through the best-corrected visual acuity(BCVA), intraocular pressure(IOP), examination of slit lamp, examination of the ocular fundus and B-mode ultrasongography from January 2012 to June 2014 was taken. All patients were treated by 25G micro-incision vitrectomy. At 1wk, 1, 3 and 6 mo after the surgeries, the BCVA was retrospectively observed. The changes of IOP, inflammatory reaction and the ocular fundus were observed. RESULTS: The BCVA was light perception in 16 eyes, hand moving in 82 eyes, finger counting in 49 eyes, 0.01~0.09 in 38 eyes, 0.1~0.2 in 23 eyes pre-operatively. At 6mo after operations, the BCVA were hand moving in 1 eyes, finger counting in 2 eyes, 0.01~0.09 in 31 eyes, 0.1~0.2 in 29 eyes, >0.2 in 145 eyes. The BCVA of all patients kept stable or increased after operations and the difference before and after the operation was statistically significant (Z=-4.128, P=0.000). The pre-operative mean IOP was 15.29±3.62mmHg. The mean IOP was 13.67±4.93mmHg at 6mo after operations. There were 96 eyes (46.2%) due to diabetic retinopathy, 37 eyes (17.8%) due to branch retinal vein obstruction, 9 eyes (4.3%) due to central retinal vein obstruction, 13 eyes (6.25%) due to retinal periphlebitis, 13 eyes (6.25%) due to polypoidal choroidal vasculopathy(PCV), 5 eyes (2.4%) due to large retinal aneurys, 19 eyes (9.1%) due to retinal hole, 16 eyes (7.7%) due to Terson syndrome. Phacoemulcification was performed for 23 eyes(11.1%) during operations. There were 145 eyes (69.7%) with perfusion fluid, 21 eyes (10.1%) with C₃F₈ gas tamponade, 17 eyes (8.2%) with air tamponade, 25 eyes (12.0%) with silicone oil tamponade. There were 12 eyes (5.8%) with transient hypotony, 8 eyes (3.8%) with increased IOP, 19 eyes (9.1%) with inflammation in anterior chamber, and 10 eyes (4.8%) with vitreous hemorrhage after the surgery. There were no ocular or systemic adverse events observed in other patients. CONCLUSION: The 25G micro-incision vitrectomy is an effective and safe treatment for the patients with vitreous hemorrhage because of small injury, short operation time, quick recovery.