Pneumatic Displacement of Submacular Hemorrhage

Drs. Sunir J. Garg and Murtaza K. Adam demonstrate their technique for management of submacular hemorrhage secondary to neovascular AMD. Following a standard vitrectomy, a posterior vitreous detachment is induced by elevating the posterior hyaloid. Next, a 41-gauge cannula is used to slowly inject tissue plasminogen activator solution into the subretinal space, creating a bleb. A small amount of air is also injected to aid in clot disruption. The procedure is concluded with an air-fluid exchange for pneumatic displacement of the submacular hemorrhage.