Hemostatic effects of air versus fluid in diabetic vitrectomy.
The potential hemostatic effect of an intravitreal air bubble after diabetic vitrectomy was studied in an animal model and in a randomized clinical trial. One day after vitrectomy with induced intraoperative hemorrhage, vitreous cavity hemorrhage was present in 60% of air-filled rabbit eyes compared with 27% of fluid-filled eyes. The prevalence and extent of hemorrhage was equal in the two groups on postoperative days 3 and 7. In a clinical trial of 51 eyes undergoing diabetic vitrectomy, 70% of eyes randomized to air-filled vitreous cavity after vitrectomy had vitreous cavity hemorrhage on postoperative day 1 compared with 50% of fluid-filled eyes. At 1 week, the incidence of hemorrhage was 78% for air and 61% for fluid. The 6-month visual and anatomic results were similar in both groups. These findings suggest that an intravitreal air bubble neither improves hemostasis nor reduces the visual outcome after diabetic vitrectomy.
Joondeph
B C
BC
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine.
Blankenship
G W
GW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D000818:Animals; D001826:Body Fluids; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011817:Rabbits; D016032:Randomized Controlled Trials as Topic; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000517:prevention & control