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Post vitrectomy vitreous hemorrhage is the main cause of failure in patients with proliferative diabetic retinopathy, the rate of this complication is 25 -65% of cases. Most of surgeon usually perform vitrectomy again, sometimes with gas tamponade for haemostatic effect. We propose to do more easy procedure – outpatient fluid gas exchange.

Purpose:

To study the effectiveness of the outpatient fluid gas exchange in the treatment of post vitrectomy vitreous hemorrhage in patients with proliferative diabetic retinopathy.

Material and methods: 

There were observed 98 patients (98 eyes) with proliferative diabetic retinopathy, who had post vitrectomy vitreous hemorrhage high density during 55 to 78 days after vitrectomy. Initial visual acuity in majority of cases was counting fingers in 62 eyes (63,3%). The method was conducted as follows: A 29 G needle was introduced intravitreally 4 mm from the limbus while the patient was sitting at 6 O’clock. The doctor gradually introducing into the vitreous cavity 20% concentration of air gas mixture of perfluoropropane with simultaneous aspiration of opaque vitreous fluid usually 4 -4,5 ml . The patient was kept face down position during 7 days. Follow up examination was in a period of 2 and 6 months.

Results:

Any complications were observed during procedure. On the next day after surgery in 5 cases were blood in anterior chamber which dissolved spontaneously. In a period of 2 months in 82 eyes (83,7%) vitreous content was transparent, in other cases remained vitreous opacity. Visual acuity considerably increased. After 6 months transparency of vitreous content was achieved in 94 cases (95,9%), recurrence of vitreous hemorrhage was observed in 19 cases (19,4%). Important to emphasize, that there were performed 3 procedures on 11 eyes and 2 procedures on 2 eyes for achievement of vitreous fluid transparency.

Conclusion:

Fluid gas exchange of 20% concentration of the air-gas mixture of perfluoropropane is highly effective treatment of post vitrectomy vitreous hemorrhage in patients with proliferative diabetic retinopathy and allows in 95,9% of cases achieve stable results of treatment in a period of 6 months of observation.