Dr. MOHIT DOGRA

, DR. RAMANDEEP SINGH, Dr. SIMAR RAJAN SINGH

Abstract

To highlight the surgical technique and outcomes of vitrectomy with subretinal tissue plasminogen activator (tPA)+air injection and partial gas tamponade with propped-up positioning in patients with large to massive sized submacular haemorrhage (SMH). 3 patients, each with big (4 DD), bigger (8DD) or biggest (16DD) SMH underwent 25gauge vitrectomy with subretinal tPA ( 0.3ml of 12.5micrograms/0.1ml) and air (0.3-0.4ml) injection followed by partial sulphur hexafluoride (18%) gas tamponade and propped-up positioning. 2 patients had SMH secondary to a ruptured arterial macroaneurysm (RAM) while the third developed it due to polypoidal choroidal vasculopathy (PCV). All patients had complete displacement of SMH at three months follow-up with improvement in visual acuity. None of the patients had any intraoperative or early postoperative complications. Vitrectomy with submacular pneumatic displacement is an efficient technique to manage patients with large to massive SMHs.