title: Early vitrectomy for vitreous hemorrhage associated with retinal tears.
abstract: OBJECTIVE
  To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears.
  
  
  METHODS
  Retrospective, noncomparative interventional case series.
  
  
  METHODS
  We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main outcome measures were incidence of tears identified preoperatively and intraoperatively, visual acuity, and complications.
  
  
  RESULTS
  Vitrectomy took place after a mean delay of 2.7 days after presentation. A total of 69 tears were found in 40 eyes; 53.7% of tears were identified preoperatively by funduscopy or ultrasound (U/S) and the remaining 46.3% of tears were only identified during vitrectomy. Visual acuity improved significantly from 1/60 to 0.8. The sensitivity of U/S tear detection was 55.9%. A history of predisposing factors was not related to the risk of presence of unsupported tears. In 2 cases a retinal detachment developed between the U/S evaluation and vitrectomy. Postoperative complications were cataract (30%), macular pucker (2.5%), and retinal detachment (5.0%).
  
  
  CONCLUSIONS
  Our findings illustrate the potential dangers of a conservative approach to vitreous hemorrhage and show that early vitrectomy has good outcome with acceptable complication rates. Prospective studies on optimal treatment of vitreous hemorrhage associated with tears are needed.
authors.affiliation: Department of Ophthalmology, Academic Medical Center, University of Amsterdam, The Netherlands. h.tan@amc.uva.nl
authors.forename: H Stevie
authors.initials: HS
authors.lastname: Tan
authors.forename: Marco
authors.initials: M
authors.lastname: Mura
authors.forename: Heico M
authors.initials: HM
authors.lastname: Bijl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*