According to the guidelines of the Declaration of Helsinki, we have adopted strict inclusion and exclusion criteria in order to make the statistical analysis as objective as possible.
It’s a retrospective study that includes patients operated in the “F. Miulli Hospital”, situated in Acquaviva delle Fonti (Bari-Italy) and in Ophthalmology of Policlinico di Bari (Italy) between 01/01/2018 and 31/01/2020. We considered 93 patients: 51 men (54.8%) and 42 women (45.2%) (Fig. 1) with an average age of 68,65 years old.
In order to avoid any influence during fundus examination and surgical variabilities, only pseudophakic patients presenting an acute vitreous hemorrhage dense enough to obscure the retina, were admitted to our study.
We have considered two types of fundus obscuring VH: 1) moderate VH, where optic disc and retinal vessels are barely visible; 2) severe VH, where hemorrhage is dense to avoid the visualization of optic disc.
Following patients have been excluded from the study: diabetics patients, patients on antiplatelet therapy, patients with diseases in the contralateral eye, patients with blood dyscrasias or who have other ocular diseases such as history of retinopathy, history of PDV in the affected eye, macular degeneration, ocular vascular thrombosis recent trauma.
All the patients involved underwent to a careful preoperative ophthalmic examination, i.e.: visual acuity with EDTRS charts (converted to LogMAR for statistical reasons); Ocular tonometry (Perkins Tonometer); Funduscopy by indirect ophthalmoscope; Ultrasound investigation, performed using a SONOMED V-MAX ultrasound with a 10 MHz B-probe. Blood tests have been performed on each patient to exclude diabetics patients.
In all cases the surgery was performed within seven days from the hemorrhage onset relying the idea that early vitrectomy could improve the prognosis of these patients.
After sub-Tenon’s anesthesia with ropivacaine, it was performed a three ports vitrectomy (25 gauge system, Alcon Constellation System) that allowed to realize a core vitrectomy and successively a meticulous shaving of vitreous in periphery (6).
In case of retinal tears detection, an intraoperative laser treatment has been added.
A specific type of tamponade system (air, sf6 gas, silicon oil 1000 cts) was chosen, depending on the surgical needs. A follow-up of 12 months was carried out and data were retrieved from an electronic patient clinical report.
Statistical analysis was performed using ‘’R statistical software version 3.5.1’’. VA before and after surgery was compared using the Paired t-test (P < 0.05 was considered statistically significant).