The surgical management of massive intraoperative and postoperative suprachoroidal hemorrhage: anatomic and functional outcomes

Abstract

Purpose: To describe the clinical characteristics, management and treatment outcomes of patients with post-surgical suprachoroidal hemorrhage (SCH). Methods: A retrospective cross-sectional study was conducted, in which the medical records of 9 consecutive patients with SCH admitted to the Goldschleger Eye Institute were reviewed. Results: The mean age was 74 years (range 61-84) and the mean follow-up time was 38.3 ± 0.1 months (range 4-87 months). Four cases were associated with glaucoma surgeries (2 trabeculectomies and 2 Ahmed valve implantations), 3 cases with cataract surgery and 2 cases with pars plana vitrectomy. The diagnosis of SCH was ranging from intra-operative to 8 days following the primary procedure. Most patients underwent posterior sclerotomies and drainage alone or combined with pars plana vitrectomy in a mean timing of intervention of 11 ± 4 days. At one month of follow-up the visual acuity improved in 7 eyes and remained stable in 2, compared to the VA prior to the drainage operation. The mean VA improved from 2.03 to 1.285 logMAR units at 1 month following the drainage procedure (p=0.003). Conclusions: SCH still remains a challenging complication of many ophthalmological procedures. The current surgical management may improve visual acuity though the general prognosis is still poor.

Massive suprachoroidal hemorrhage: Surgical management and outcome

“…While the VA of case 3 improved to hand motions, case 2 had a better result with a final VA of 20/320. The excellent functional outcome of 20/20 in case 1 is remarkable and differs from other studies that report a generally poor functional outcome after surgical treatment of massive SCH [ 3 ], [ 7 ], [ 18 ], [ 20 ], [ 23 ], [ 24 ]. Patient 1 was the only case of intraoperative SCH in our study and an immediate tamponade was performed by fast suturing of all surgical incisions.…”

“…Systemic risk factors associated with SCH are advanced age, systemic hypertension, arteriosclerosis, blood coagulation defects, intraoperative tachycardia, and diabetes mellitus [ 18 ]. Ocular risk factors for the development of SCH during intraocular procedures comprise glaucoma, elevated IOP, high myopia, aphakia, and pseudophakia [ 9 ], [ 10 ], [ 14 ], [ 16 ], [ 19 ].…”

“…Ocular risk factors for the development of SCH during intraocular procedures comprise glaucoma, elevated IOP, high myopia, aphakia, and pseudophakia [ 9 ], [ 10 ], [ 14 ], [ 16 ], [ 19 ]. The surgical management of SCH includes drainage through posterior sclerotomies, often combined with vitrectomy, and silicone oil instillation [ 3 ], [ 7 ], [ 18 ]. As most studies published to date are limited and report poor functional outcomes despite surgical intervention [ 3 ], [ 7 ], [ 19 ], [ 20 ], the present study focuses on timing, surgical management, and anatomic and functional results of four cases of massive SCH.…”

Long Term Results Of Refractory Glaucoma Cases With Ahmed Glaucoma Valve Implantation

“…Suprakoroidal hemoraji tek bir vakada, afakik glokom vakasında, erken postoperatif dönemde gelişti ve cerrahi drenaj uygulanmak durumunda kalındı. Literatürde de AGV implantasyonu sonrası suprakoroidal hemoraji gelişimi bildirilmiştir 14,15 .…”

Retinoblastoma presenting as haemorrhagic choroidal detachment in a 10-year-old girl

“…Spontaneous haemorrhagic choroidal detachment is a rare, sight-threatening condition where choroidal haemorrhage detaches the intraocular contents from the sclera 3. The predisposing factors of this condition include advanced age (>60 years old), systemic hypertension, arteriolosclerosis, blood coagulation defects, intraocular mass, diabetic mellitus and intraoperative tachycardia 4. In incisional intraocular surgery, haemorrhagic choroidal detachment is one of the most dreaded complication 5.…”