Application of an improved subretinal injection system in the treatment of submacular hemorrhage: a single-center, retrospective study
10.3760/cma.j.cn511434-20250120-00031
- VernacularTitle:一项改良视网膜下注射系统在黄斑下出血治疗中的应用：单中心、回顾性研究
- Author:
Ying HE
1
;
Xufeng ZHAO
;
Liwei WEI
;
Zheng ZHANG
;
Shengjie ZHANG
;
Li LIU
;
Youxin CHEN
;
Weihong YU
;
Hanyi MIN
;
Huizhen WANG
Author Information
1. 中国医学科学院北京协和医院手术室, 北京 100730
- Publication Type:Journal Article
- Keywords:
Submacular hemorrhage;
Polypoidal choroidal vasculopathy;
Subretinal injection;
Vitreoretinal surgery
- From:
Chinese Journal of Ocular Fundus Diseases
2025;41(10):769-774
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a simple and effective subretinal injection pipeline system to enhance the accuracy and precision of subretinal injection volume control.Methods:A retrospective case series study. From May to October 2023, 18 patients (18 eyes) with submacular hemorrhage (SMH) who continuously received modified subretinal injection treatment in Department of Ophthalmology of Peking Union Medical College Hospital were included in the study. Among them, there were 10 males and 8 females. The mean age was (60.00±7.41) years. The primary causes included polypoid choroidal vasculopathy (14 cases), retinal macroaneurysm (2 cases), traumatic retinopathy (1 case), and Valsalva retinopathy (1 case). Hemorrhage affected 14 eyes of the fovea centralis. All affected eyes underwent standard three-channel 25G vitrectomy via the flat part of the ciliary body combined with modified subretinal injection of recombinant tissue plasminogen activator. The improved injection system consisted of a 1 ml syringe, a Q-Syte TM connector, a 41G subretinal microinjection needle, a converter and a viscoelastic substance control pipeline. The drug preparation time for subretinal injection (i.e., the time consumed by the system connection step), the injection time, whether bubbles occur during the injection process, and the perioperative complications were recorded and analyzed. Results:The preparation time prior to drug injection ranged from 230 to 335 seconds, while the injection completion time varied between 43 and 75 seconds. Both times decreased progressively as operator proficiency improved. Among the treated eyes, five received a target injection dose of 0.05 ml and thirteen received 0.10 ml, with all eyes achieving the preset dose accurately. No subretinal bubbles were observed during the injection procedure. Additionally, no intraoperative complications such as retinal hemorrhage or tear secondary to mechanical trauma at the injection site were recorded. Postoperatively, one eye developed anterior chamber hemorrhage, which resolved following intraocular pressure-lowering treatment. No other postoperative complications, including hemorrhage, rhegmatogenous retinal detachment, or infection, were observed in the remaining eyes.Conclusion:The retinal drug injection system developed in this study has a simple structure, safe and stable operation, can achieve precise drug injection, and effectively avoid the formation of bubbles.
