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Presumed sclerotomy site bleeding inflowing into the anterior chamber after the removal of a 23-gauge microcannula in 23-gauge sutureless vitrectomy.

Nam DH, Yoon SC, Lee DY, Sohn HJ - Indian J Ophthalmol (2010 Nov-Dec)

Bottom Line: Soon after the removal of a 23-gauge microcannula at the end of the surgery, presumed sclerotomy site hemorrhage was rapidly fluxed into the anterior chamber.We could not find any vitreous hemorrhages.The hemorrhage within the anterior chamber spontaneously absorbed within 14 days.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, South Korea.

ABSTRACT
We experienced two cases of the influx of the sclerotomy site bleeding into the anterior chamber during 23-gauge sutureless vitrectomy for pseudophakic rhegmatogenous retinal detachment. Soon after the removal of a 23-gauge microcannula at the end of the surgery, presumed sclerotomy site hemorrhage was rapidly fluxed into the anterior chamber. The anterior chamber bleeding might come from the sclerotomies rather than from episcleral vessels. The posterior pressure in the gas-filled pseudophakic eye might have pushed the sclerotomy site bleeding into the anterior chamber. We could not find any vitreous hemorrhages. The hemorrhage within the anterior chamber spontaneously absorbed within 14 days.

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Related in: MedlinePlus

Sequential intraoperative photographs (A–C). (A) No hemorrhagic sign at the end of vitrectomy. (B) About 20 s after the removal of the cannulae, hemorrhage starts inflowing into the anterior chamber from the superonasal area of the limbus (yellow arrow). (C) Anterior chamber hemorrhage. (D) Slit-lamp photograph at the postoperative 7 days showing a clear anterior chamber
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Figure 0002: Sequential intraoperative photographs (A–C). (A) No hemorrhagic sign at the end of vitrectomy. (B) About 20 s after the removal of the cannulae, hemorrhage starts inflowing into the anterior chamber from the superonasal area of the limbus (yellow arrow). (C) Anterior chamber hemorrhage. (D) Slit-lamp photograph at the postoperative 7 days showing a clear anterior chamber

Mentions: Vitreous surgery was carried out using a 23-gauge vitreous cutter and the DORC two-step system. During the surgery, there were no specific events. Endolaser photocoagulation and air-gas (12% C3F8) exchange were performed. At the end of the surgery, the three microcannulae were withdrawn from the scleral tunnel and the immediate postoperative tactile IOP felt normal [Fig. 2A]. About 20 s after the removal of the cannulae, the anterior chamber hemorrhage was noticed [Fig. 2B]. It was slowly inflowing from the superonasal area of the chamber [Fig. 2C]. Meanwhile, there was neither subconjunctival hemorrhage nor chemosis in the superonasal sclerotomy site. Surgery was completed without any additional procedure. Postoperatively, we could not find any vitreous hemorrhages and the sclerotomy was well closed. The anterior chamber hemorrhage was completely absorbed within 7 days [Fig. 2D] and the IOP maintained was 17 mmHg. Six months after the surgery, BCVA was 20/40 and fundus examination revealed a flat retina.


Presumed sclerotomy site bleeding inflowing into the anterior chamber after the removal of a 23-gauge microcannula in 23-gauge sutureless vitrectomy.

Nam DH, Yoon SC, Lee DY, Sohn HJ - Indian J Ophthalmol (2010 Nov-Dec)

Sequential intraoperative photographs (A–C). (A) No hemorrhagic sign at the end of vitrectomy. (B) About 20 s after the removal of the cannulae, hemorrhage starts inflowing into the anterior chamber from the superonasal area of the limbus (yellow arrow). (C) Anterior chamber hemorrhage. (D) Slit-lamp photograph at the postoperative 7 days showing a clear anterior chamber
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2993992&req=5

Figure 0002: Sequential intraoperative photographs (A–C). (A) No hemorrhagic sign at the end of vitrectomy. (B) About 20 s after the removal of the cannulae, hemorrhage starts inflowing into the anterior chamber from the superonasal area of the limbus (yellow arrow). (C) Anterior chamber hemorrhage. (D) Slit-lamp photograph at the postoperative 7 days showing a clear anterior chamber
Mentions: Vitreous surgery was carried out using a 23-gauge vitreous cutter and the DORC two-step system. During the surgery, there were no specific events. Endolaser photocoagulation and air-gas (12% C3F8) exchange were performed. At the end of the surgery, the three microcannulae were withdrawn from the scleral tunnel and the immediate postoperative tactile IOP felt normal [Fig. 2A]. About 20 s after the removal of the cannulae, the anterior chamber hemorrhage was noticed [Fig. 2B]. It was slowly inflowing from the superonasal area of the chamber [Fig. 2C]. Meanwhile, there was neither subconjunctival hemorrhage nor chemosis in the superonasal sclerotomy site. Surgery was completed without any additional procedure. Postoperatively, we could not find any vitreous hemorrhages and the sclerotomy was well closed. The anterior chamber hemorrhage was completely absorbed within 7 days [Fig. 2D] and the IOP maintained was 17 mmHg. Six months after the surgery, BCVA was 20/40 and fundus examination revealed a flat retina.

Bottom Line: Soon after the removal of a 23-gauge microcannula at the end of the surgery, presumed sclerotomy site hemorrhage was rapidly fluxed into the anterior chamber.We could not find any vitreous hemorrhages.The hemorrhage within the anterior chamber spontaneously absorbed within 14 days.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, South Korea.

ABSTRACT
We experienced two cases of the influx of the sclerotomy site bleeding into the anterior chamber during 23-gauge sutureless vitrectomy for pseudophakic rhegmatogenous retinal detachment. Soon after the removal of a 23-gauge microcannula at the end of the surgery, presumed sclerotomy site hemorrhage was rapidly fluxed into the anterior chamber. The anterior chamber bleeding might come from the sclerotomies rather than from episcleral vessels. The posterior pressure in the gas-filled pseudophakic eye might have pushed the sclerotomy site bleeding into the anterior chamber. We could not find any vitreous hemorrhages. The hemorrhage within the anterior chamber spontaneously absorbed within 14 days.

Show MeSH
Related in: MedlinePlus