ABSTRACT
Intraoperative hemorrhage can accumulate in the vitreous cavity or in the subretinal space. Any eye for which a pars plana vitrectomy is planned needs a careful and complete preoperative evaluation to devise a surgical plan and anticipate common sources of intraocular hemorrhage. For vitrectomy, two infusion bottles are used in the set-up: one with a thrombin mixture and the other with regular infusion fluid. A simple and common technique for controlling intraocular hemorrhage is raising the intraocular pressure (IOP). The IOP is elevated by raising the height of the infusion bottle or by increasing the air pressure in the infusion. Increasing the IOP to achieve hemostasis may damage intraocular structures that are sensitive to ischemia, particularly in eyes with diabetic retinopathy or glaucoma. Additionally, the IOP can be raised by increasing the air/gas pump pressure to slow the blood flow through the injured vessels and hasten thrombosis.
