Simultaneous injection‐aspiration technique of air/fluid exchange for in‐office treatment of post‐operative vitreous cavity hemorrhage

BACKGROUND: Post-operative vitreous cavity hemorrhage following pars plana vitrectomy is common. In-office drainage of the hemorrhage may be an option for some patients. TECHNIQUE: A new method for office-based air fluid exchange is described. A 30-gauge needle with a 10-mm syringe filled with sterile air is inserted 3.5-mm posterior to the limbus in the superotemporal quadrant. A second 30-gauge needle is inserted 3.5 mm from the limbus at 6 o’clock and connected to an empty 10-mm syringe with intravenous catheter tubing. The plunger of the air-filled syringe is pushed while the plunger of the empty syringe is pulled, so that the rate of fluid aspiration matches the rate of air injection. DISCUSSION: The method approximates conditions in pars plana vitrectomy, with balanced infusion and aspiration. Displaced vitreous cavity contents are collected in the aspiration syringe. The procedure is also cost effective. CONCLUSION: The simultaneous syringe method is an easy, safe, and effective way of clearing post-operative vitreous cavity hemorrhage.