Hassan Mortada (Cairo, Egypt)

Advantages: 

One hundred and eighty degree peripheral temporal retinotomy, just posterior to the ora serrata allows free access to the sub-retinal space.  It allows complete removal of unabsorbed sub macular blood clot secondary to retinal arterial macroaneurysms.  Peripheral retinotomies are associated with less risk of epiretinal proliferation than central retinotomies and is not complicated by central visual field defects.

Methods: 

Four eyes with unabsorbed clotted sub macular hemorrhage underwent combined phacoemulsification with lens implantation and pars plana vitrectomy for evacuation of the blood clot.  One hundred and eighty degree temporal peripheral retinotomy was performed to allow access to sub-retinal space for complete removal of the blood clot. The retina was reattached with PFCL and the eye was filled with silicone oil. The oil was removed after 3 months.  No operative or postoperative complications were encountered. Visual acuity improved in all 4 eyes.

Effectiveness / Safety: 

One hundred and eighty degree peripheral temporal retinotomy is safe and effective in removal of unabsorbed, clotted sub macular blood secondary to retinal arterial macroaneurysms.

Take home message:

For unabsorbed clotted sub-macular hemorrhage secondary to retinal arterial macroaneurysm, one should consider evacuation through temporal peripheral retinotomy.