Intravitreal Thrombin Injection for Control of Hemorrhage During the Vitreous Surgery

Kim, Tae Yon; Kwon, Oh Woong; Lee, Sung Chul

Abstract

Intraocular hemorrhage is a major problem during the vitreous surgery, despite of improvements in instrumentation and operative methods. Infusion of thrombin has been reported as an efficacious method of control of intraocular hemorrhage in various vitreous surgery. In this study, 100 U/ml diluted thrombin was injected through the infusion system of Grieshaber manipulator into the vitrous cavity on the bleeding site instead of adding to the infusion solution in 10 cases of vitreous surgery including proliferative diabetic retinopathy, posttraumatic advanced proliferative vitreoretinopathy and giant retinal tear. As the result, all cases of intraocular hemorrhage were controlled within 2 min utes after the injection of thrombin, with the combined use of intraocular diathermy or elevation of intraoclar pressure. The amount of diluted thrombin which was injected in concentration of 100 U/ml, was less than 5ml. The 6 cases of postop erative complication were noted, including 2 cases of vitreous hemorrhage and 4 cases of hypopyon which were controlled within 5 days with topical steroid therapy.