Suprachoroidal Hemorrhage

Abstract

Suprachoroidal hemorrhage is a feared complication of all types of intraocular surgery. Although rare, it is typically associated with severe visual disability, and this has prompted efforts to better understand the pathogenesis of this condition, to identify the patients at risk for this event, and to improve treatment of patients who develop this condition either intraoperatively or postoperatively. Controversy still exists regarding the best course of treatment for these patients. Although the introduction of perfluorocarbon liquids as a surgical adjunct during vitrectomy surgery may assist in the removal of suprachoroidal hemorrhage, the visual outcomes still remain disappointing.

Spontaneous suprachoroidal haemorrhage following a valsalva manoeuvre

“…1 It has been reported to occur in all types of intraocular procedures. 2 Sudden hypotony is thought to be responsible for the haemorrhage.…”

“…Headache, nausea and vomiting may also accompany the ocular pain. 1 Suprachoroidal haemorrhage after valsalva manoeuvre has been reported in patients either on systemic anticoagulants, treated with streptokinase or in eyes with previous ocular surgery (scleral buckle). [2][3][4][5] To our knowledge, this is the first reported case of spontaneous choroidal haemorrhage in an individual who is not on any anticoagulants or has had no past history of ocular surgery.…”

Modified cow-hitch suture fixation of transscleral sutured posterior chamber intraocular lenses: Long-term safety and efficacy

“…This minimizes the amount of time the globe is open, thus reducing the risks for postoperative complications such as expulsive choroidal hemorrhage, which is considered to be related to increased surgical time and manipulation. 17,18 Tilt and decentration of an IOL can result in significant visual disturbances. Holladay 19 found that decentration greater than 1.0 mm causes radial astigmatism and tilt greater than 15 degrees causes coma aberration that cannot be corrected with spectacles.…”

Healon5 in the management of intraoperative expulsive hemorrhage

“…1,5 In patients with multiple risk factors for choroidal hemorrhage, we recommend having Healon5 available in the surgical field for management of this potential problem.…”