Clinical Outcomes of Multiple-Shot Nd:YAG Laser Hyaloidotomy for Premacular Subhyaloid Haemorrhage in Proliferative Diabetic Retinopathy

Aim: To evaluate the efficacy of Nd:YAG laser hyaloidotomy using multiple shots for organized premacular subhyaloid haemorrhage with clotted blood in proliferative diabetic retinopathy (PDR). Methods: This interventional case series included 15 eyes. Pre and post visual acuity, number of laser shots, total energy, time to clearance of premacular blood, and complications were recorded. Results: Pre-laser visual acuity ranged 5/60 or worse. At 3 weeks post-procedure, 66.7% of the eyes achieved visual acuity better than 6/24. The mean number of laser shots required was 19.5 ± 3.7 and the mean total energy used was 186.7 ± 46.4 mJ. Mean time for disappearance of premacular blood was 17.4 ± 3.8 days. Post-laser vitreous haemorrhage occurred in 15 eyes (100%) of which 5 (33.3%) were severe. Five eyes required pars plana vitrectomy and all had visual improvement after surgery. Conclusion: Nd:YAG hyaloidotomy provides an early, cost-effective alternative to vitrectomy for selected PDR patients with organized premacular haemorrhage.