Suprachoroidal hemorrhage (SCH) is a rare but serious sight-threatening complication of inner eye surgery. Despite continuous advances in treatment, visual prognosis remains poor. The disease has a more typical clinical presentation, the etiology and pathogenesis are not well defined, and intraoperative ocular and systemic factors may induce fulminant SCH. To investigate risk factors and treatments of SCH-associated intraocular surgeries, summarize diagnosis, characteristics, management, and prevention of SCH developed during and after intraocular surgeries. A retrospective study of SCH occurred in six cases of intraocular surgeries including cataract, glaucoma, pars plana vitrectomy (PPV), and silicone oil removal surgery. Assess baseline systemic and ocular characteristics of SCH eyes. Analyze the second surgery timing and technique, and visual outcomes were measured. SCH occurred in six patients including five eyes during surgeries and one eye after the surgery. Three eyes that underwent cataract surgery had hard nucleuses (nuclear sclerotic 4+). One eye was due to hypotony during the vitrectomy procedure. One eye developed SCH when silicone oil was extracted from the eyeball. One eye developed delayed SCH after glaucoma surgery. Incision closure and anterior chamber deepening were performed. B-scan ultrasonography was used to diagnose SCH, and determine the timing and location of sclerotomy for the second surgery. Vitrectomy and sclerotomy were performed in five eyes. The median follow-up time was six months. The final best-corrected visual acuity (BCVA) was 0.3 in one eye, one eye had light perception with retinal adherence, and four eyes had no light perception with retinal detachment. The results showed that risk factors including advanced age, hypertension, taking anticoagulants, antiplatelet drugs, and cardiovascular drugs were systemic risk factors, and hard nucleus (nuclear sclerosis 4 +) cataract, long-term uncontrolled ocular hypertension glaucoma, vitrectomy, silicone oil removal, high myopia, aphakia, previous intraocular surgery, intraocular pressure during surgery, and others were ocular risk factors. The most important risk factor is a sudden drop in intraocular pressure during or after surgery. The outcome of visual acuity depends on retinal status. Because of the poor prognosis, the prevention of SCH is of utmost importance during intraocular surgery.

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The purpose of this study was to investigate the effectiveness and practicability of phacoemulsification and intraocular lens implantation for subluxated cataracts. A retrospective review of subluxated cataract surgeries of 19 eyes performed in Kunhua Hospital Affiliated with Kunming University of Science and Technology between January 2017 and June 2021 was conducted. We choose to use the rotate-and-chop phacoemulsification techniques described when the crystal nucleus is rotated out of the capsular bag and simultaneously perform horizontal chops over the capsule. The viscoelastic agent was the important material that filled the capsule to support the capsular bag, and capsular hooks were used in 10 eyes necessarily. Anterior vitrectomy was undergone in 15 eyes. Single-piece intraocular lenses (IOL) were implanted in the capsular bag in 12 eyes including 8 capsular tension ring (CTR) implantation. Three-piece IOLs were fixed scleral layer in 7 eyes. Follow-up was 6 months to 2 years, and all eyes were successfully implanted with centered IOL. The best corrected visual acuity (BCVA) increased from 0.06 ± 0.04 to 0.62 ± 0.15 . The cornea of all patients was clear, the intraocular lens was centered, the pupil was round, and the intraocular pressure was normal. Subluxated cataracts are a challenging surgery. The technique of phacoemulsification in subluxated cataract surgery is a key procedure to rotate and remove the lens from the capsule and at the same time horizontal chops and emulsification over the capsular bag to be performed. Viscoelastic agents and capsular hooks were important choices to support the capsule to reduce the incidence of complications related to the vitreous and retina and prevent the range enlarging of the zonular dialysis. A capsular tension ring was also an effective device to maintain capsular stability. Double-needle-guided scleral interlamellar fixation is an effective and practical method for IOL. Overall, the incision technique explored in this study and the surgical technique to support capsular stabilization provide a safe approach and satisfactory results in cataract surgery for subluxation.