Sub-retinal hemorrhage during internal limiting membrane peeling for a macular hole

Purpose: To report the occurrence of sub-retinal hemorrhage during peeling of the internal limiting membrane (ILM). Case reports: In case 1, a three-port pars plana vitrectomy was performed on a 57-year-old woman with a macular hole. Following the staining of the ILM with indocyanine green, the ILM was peeled with forceps, and a sub-retinal and vitreous hemorrhage resulted from a vein during the peeling. The bleeding was stopped by elevating the intraocular pressure. The final visual acuity was 20/30. In case 2, similar procedures were performed on a 68-year-old woman with a macular hole. A sub-retinal hemorrhage occurred while peeling the ILM. The pre-operative visual acuity was 20/300, and final visual acuity was 20/200. Conclusions: Surgeons should be aware that sub-retinal and vitreous hemorrhage can be a complication of ILM peeling.