Nd: YAG laser treatment for premacular hemorrhage

To investigate the effects of drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser in 13 eyes of 12 patients in a 3 months followup period. This study was conducted from January 2001 to December 2001. Thirteen eyes of 12 patients had a circumscribed premacular hemorrhage and were treated with Nd: YAG laser to drain the blood into the vitreous cavity. The hemorrhage originated from diabetic retinopathy [8 eyes], retinal macroaneurysm [2 eyes], AML [2 eyes] and branch retinal vein occlusion [1 eye]. The size of the hemorrhage was expressed in disc diameters. Success of laser application was defined as clearing of premacular hemorrhage within 3 months. By this definition drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser succeeded within three months is eleven, out of thirteen eyes treated without requiring further membranotomy. One eye had persistent, dense nonclearing vitreous opacity for at least 3 months. One clotted hemorrhage did not drain into the vitreous. Overall visual improvement was best in eyes with AML and macroaneurysm. During the follow-up, neither macular epiretinal membranes nor tractional retinal detachments occurred in any eye. Drainage of premacular subhyaloid hemorrhage into the vitreous with Nd: YAG laser is a viable alternative treatment alternative for eyes with recent bleeding. However, to establish Nd: YAG laser treatment as a routine procedure, the risk and benefits have to be weighed in randomized trials and compared with those deferral of treatment or primary vitrectomy