Theodoros Potamitis (Limassol, Cyprus)

Advantages:

Without a large retinotomy massive clots of blood can be removed from the subretinal space in a simple air-fluid exchange.

Methods:

Tissue plasminogen activator is injected three days prior to surgery to liquify the clotted blood. A standard three-port vitrectomy is then performed and through a 20G retinotomy and using air-fluid exchange the subretinal blood is evacuated.

Effectiveness / Safety:

This is a very effective and safe method of treating otherwise very complex detachments.

Take home message:

Allow three days for the tPA to work, avoid large retinotomies and RPE exposure.