Nd: YAG Laser Treatment for Premacular Subhyaloid Haemorrhage in Childhood Acute Leukemia

1. Deepak Khadka
2. J.K. Shrestha
3. A.K. Sharma

1. Geta Eye Hospital, Dhangadi, Nepal
2. BP Koirala Lions Centre for Ophthalmic Studies, Kathmandu, Nepal
3. BP Koirala Lions Centre for Ophthalmic Studies, Kathmandu, Nepal

Objectives: To investigate the effects of Nd: YAG Laser hyaloidotomy in 11 eyes of 8 patients with Premacular haemorrhage in acute Childhood leukemia.

Methods: Premacular Subhyaloid haemorrhage is one of the leading causes of visual disability in children with acute leukemia. Eleven eyes of 8 patients attending to Kanti Children Hospital and BP Koirala Lions Centre for Ophthalmic Studies from January 2006 to July 2007 with Premacular Subhyaloid haemorrhage were included in the study and treated with Nd: YAG Laser. The haemorrhage originated from AML in 4 cases (6 eyes) and ALL in 4 cases (5 eyes).

Results: Drainage of Premacular Subhyaloid haemorrhage into vitreous cavity within 3 months succeeded in 9 eyes out of 11 eyes treated. One eye had dense clotted haemorrhage and the other had rebleed. Overall visual improvement was equal in both AML and ALL cases. No obvious epiretinal membrane, retinal breaks and tractional retinal detachment occurred in any eye.

Conclusion: Nd: YAG Laser hyaloidotomy is relatively safe, simple and alternative treatment for eyes with dense Premacular Subhyaloid haemorrhage in acute childhood leukemia.
The risks and benefits have to be weighted in randomized clinical trials to establish Nd: YAG hyaloidotomy treatment as a routine procedure in leukemic children.