Healon as A Usefull Adjunct in PDR Vitrectomy

Introduction: The incidence of macular hemorrhage as a post-operative complication of vitrectomy for PDR is not infrequent. The precarious location of the hemorrhage over the macular area precludes rapid visual recovery after the surgical intervention.Purpose: We conducted a prospective study with the aim of investigating the efficacy of intraoperative injection of healon over the posterior pole of the eye at the end of the vitrectomy operation. Healon was injected in the air filled eye to act as a cushion diverting the post-operative ooze of blood from setting over the macula.Methodology: We recruited 50 eyes with PDR. These eyes underwent triamcinolone assisted vitrectomy. The posterior hyaloid was stripped, the pre-retinal membranes were peeled and hemostasis was secured. Endolaser photocoagulation was preformed followed by fluid/air exchange. Prior to the silicone oil tamponade, healon was injected in the air-filled eye to cover the posterior pole up to the vascular arcade. The patient was advised to lie in the supine position for 24-48 hours after the surgical intervention.Result: Forty two eyes did not bleed after the operation. However, rebleeding took place in 8 eyes. Astonishingly, in these 8 eyes the healon cushion served as an effective barrier keeping the blood away from the macula. Consequently the patients regained vision rapidly after the operation.Concusion: Healon is a friendly tool to the vitreoretinal surgeon. The healon cushion over the macula is quite effective as a barrier against encroachment of post-operative ooze of the blood onto the macula. Consequently rapid post-operative visual recovery is secured.