Modified vitreous surgery for subretinal neovascularization and hemorrhage.

PURPOSE: To modify vitreous surgery for subretinal neovascularization (SRNV) and to determine the effects of this operation.

METHODS: Six patients with SRNV were performed with this operation. The methods of examination before and after operation included: testing the best-corrected visual acuity before operation and 1, 3 or 6 months after operation; 30 degrees and macular 10 degrees Humphrey visual field examination; FFA examination preoperatively and 1, 3 or 6 months postoperatively. Modified surgery procedure is: a preventive buckling; pars plana vitrectomy; peeling the vitreous cortical; no intraocular diathermy; small retinotomy; subretinal surgery; air-fluid exchange.

RESULTS: SRNV was taken off in 4 cases. Subretinal hemorrhage was washed in 2 cases. After 4 to 7 months follow-up, the visual acuity was improved in 4 cases, unchanged in 2 cases. The visual field was improved in 4 cases, unchanged in 1 case, decraesed in 1 case. The complications included macular hole due to surgery in 1 case and subretinal hemorrage in 1 case.

CONCLUSION: The surgery criteria were: 1) massive subretinal hemorrhage; 2) some patients of SRNV included: FFA evidence they showed the membrane is beneath fovea, the best V. A is 20/100 or lower, and can't be treated by laser and the patient consent. This modified subretinal operation is safe, and effective for massive hemorrhage and some SRNVS.