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ARTICLE
Year : 1983  |  Volume : 31  |  Issue : 5  |  Page : 550-551

Closed vitrectomy in vitreous haemorrhage­ Eales' disease


Rotary Eye Institute, Dudhia Talao, Navsari, India

Correspondence Address:
A P Shroff
Rotary Eye Institute, Dudhia Talao, Navsari-396 445
India
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Source of Support: None, Conflict of Interest: None


PMID: 667175

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How to cite this article:
Shroff A P, Billore O P. Closed vitrectomy in vitreous haemorrhage­ Eales' disease. Indian J Ophthalmol 1983;31:550-1

How to cite this URL:
Shroff A P, Billore O P. Closed vitrectomy in vitreous haemorrhage­ Eales' disease. Indian J Ophthalmol [serial online] 1983 [cited 2019 Dec 15];31:550-1. Available from: http://www.ijo.in/text.asp?1983/31/5/550/36585

Table 1

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Table 1

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The treatment of vitreous haemorrhage in Eales' disease has remained far from satisfac­tory. Conventional methods to resolve the haemorrhage do not solve the problem. Therefore vitrectomy has become a procedure of choice in such cases to clear the haemorrhage and to deal with retinal problem thereafter.


  Material and Methods Top


The present study included 12 males between 21 to 30 years of age who had vitreous haemorrahage remained unresolved for 5-6 months after conventional methods like anticoagulants, vasodilators, iodine, surface diathermy or cryo and even blind photocoagula­tion in the peripheral area, have failed. Because of having unoperable retinal detachment in other eye, 3 cases were subjected to this procedure little early as they did not show slightest inclination towards spontenous absorption.

All cases were subjected to routine anterior segment examination on Slit Lamp Biomicroscope which included corneal examination applanation tonometry, gonioscopy. Lenticular examination and indirect ophthalmoscopy were done after dilating the pupils. Photographs were taken on fundus camera. Projection of light from all quadrants was especially evaluated.

Systemic examinations and biochemistry was done routinely for purpose of general anaesthesia.

Pars Plana vitrectomy was done using Peyman's vitrectomy unit modified by Dr. Nagpal.

Post operatively cases were examined at the time of discharge, after one month, 2 months, and then every 3 months up to 9 months. Photographs were taken on every visit.


  Observations Top


Operative procedure were uneventful in 10 cases. In 2 cases considerable area of retina was visible but bleeding from proliferative vessels continued inspite of our measures and ultimately procedure was discontinued.

During post operative period patients were much comfortable and no uneventful complica­tion were noticed in the anterior segment except two cases where Intraocular lesion was slightly high which was controlled by acetazolamide.

Indirect ophthalmoscopy revealed 2 eyes full of fresh blood while 3 eyes had extreme proliferative changes with retinal detachment and slight pool of blood in the vitreous. 7 cases showed good results and at places vascular changes were noticed which were later on treated with Photocoagulations. Vision improved from F.C. 3 meter to 6/6 [Table - 1]. During subsequent follow up 3 cases showed lens changes where in two cases vision did not improve at all and one improved case did show early peripheral lens opacity.


  Discussions Top


In early stage of Eales' disease haemorrhages are limited to either retina or to a retrovitreous space but when massive retrovitreous haemorr­hage extends into the gel then situation becomes a bit difficult to treat medically. Therefore closed vitrectomy has become a procedure of choice to clear the blood and once the retinal lesions are visualised one can proceed further with photocoagulation and other conventional treatment. The procedure itself is complicated and has to be carried out carefully so as to avoid undue trauma to the lens and retina. Moreover the long term follow up is required to evaluate to efficay of the procedure. Therefore it should be reserved for those cases who shows no inclination towards spontaneous absorption otherwise the results are dramatic and allows the ophthalmologist to go ahead with further treatment.


  Summary Top


A new surgical approach-closed vitrectomy in vitreous haemorrhage of Eales' disease certainly brings dramatic results. In present series of 12 cases haemorrhage cleared in 10 cases. The vision improved in 7 cases while 3 cases showed advance stage of disease. In two cases we could not succeed in clearing vitreous haemorrhage.



 
 
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