Evacuation of Vitreous Hemorrhage via Pars Plana Vitrectomy

Abstract

The decision for proceeding to surgery for removal of vitreous hemorrhage is highly dependent on its anticipated cause. Ultrasound imaging should be performed by the surgeon in the clinic prior to scheduling surgery to confirm the presence (or absence) of both traction and rhegmatogenous retinal detachments and choroidal edema or suprachoroidal hemorrhage. If a patient is a diabetic, the presumed cause will be proliferative disease. If the patient is not a diabetic, the most common causes of vitreous hemorrhage would be trauma, retinal tear secondary to PVD, avulsed retinal vessel, macroaneurysm, and neovascularization secondary to retinal vein occlusion. The clinical history and examination of the other eye will often help determine the probable cause. The patient should undergo a detailed informed consent process including the steps needed to correct the suspected cause and the inherent risks associated with vitrectomy-based surgery.