Secondary surgical management of suprachoroidal hemorrhage during pars plana vitrectomy

  • Dragan Rajko Vuković Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
  • Sanja M Petrović Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
  • Predrag D Paović Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
Keywords: vitrectomy, eye hemorrhage, intraoperative complications, risk factors,

Abstract


Introduction. Suprachoroidal hemorrhage (SCH) is one of the most feared and devastating complications of intraocular surgery. Intraoperative SCH is defined as sudden hemorrhagic swelling of the choroid which develops at time of intraocular surgery, and is associated with expulsion of some or all of the intraocular contents. Case report. A 56-year-old man was admitted to our Clinic with bullose retinal detachment in the left eye. Intraoperatively, during the substitution of perfluorocarbone liquid (PFCL) with silicone oil, which is very rare situation, a sudden loss of red reflex happened and SCH was recognized as the cause. No attempt was made to drain the suprachoroidal blood. After 3 weeks the patient was scheduled for pars plana vitrectomy. Initial drainage of liqufied blood was made through a sclerotomy port during pars plana inferotemporally. Massive epiretinal proliferation with funnel shaped retinal detachment was solved during vitrectomy and internal tamponade with silicone oil was done. Postoperative visual aquity was 2/60 on the third postoperative day. Conclusion. Although suprachoroidal hemorrhage is one of most feared and devastating complications of intraocular surgery, it might have relatively good prognosis with proper preoperative, intraoperative and postoperative management.

Author Biographies

Dragan Rajko Vuković, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
vitreoretinal,ophthalmologist
Sanja M Petrović, Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
Vitreoretinal,ophthalmologist
Predrag D Paović, Clinic of Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
vitreoretinal departement,ophthalmologist

References

Mei H, Xing Y, Yang A, Wang J, Xu Y, Heiligenhaus A. Supra-choroidal hemorrhage during pars plana vitrectomy in trauma-tized eyes. Retina 2009; 29(4): 473−6.

Beatty S, Lotery A, Kent D, O'Driscoll A, Kilmartin DJ, Wallace D, et al. Acute intraoperative suprachoroidal haemorrhage in ocu-lar surgery. Eye (Lond) 1998; 12( Pt 5): 815−20.

Chu TG, Green RL. Suprachoroidal hemorrhage. Surv Oph-thalmol 1999; 43(6): 471−86.

Spaeth GL. Suprchoroidal hemorrhage: no longer a disaster. Ophthalmic Surg 1987; 18(5): 329−33.

Speaker MG, Guerriero PN, Met JA, Coad CT, Berger A, Marmor M. A case-control study of risk factors for intraoperative su-prachoroidal expulsive hemorrhage. Ophthalmology 1991; 98(2): 202−9.

Spaeth GL, Baez KA. Long term prognosis of eyes having had operative suprachoroidal expulsive hemorhage. Ger J Oph-thalmol. 1994; 3(3): 159−63.

Lambrou FH, Meredith TA, Kaplan HJ. Secondary surgical man-agement of expulsive choroidal hemorrhage. Arch Ophthalmol 1987; 105(9): 1195−8.

Tabandeh H, Sullivan PM, Smahliuk P, Flynn HW, Schiffman J. Suprachoroidal hemorrhage during pars plana vitrectomy. Risk factors and outcomes. Ophthalmology 1999; 106(2): 236−42.

Sharma YR, Gaur A, Azad RV. Suprachoroidal haemorrhage. Secondary management. Indian J Ophthalmol 2001; 49(3): 191−2.

Lakhanpal V. Experimental and clinical observation on mas-sive suprachoroidal hemorrhage. Trans Am Ophthalmol Soc 1993; 91: 545−652.

Tabandeh H, Flynn JH. Suprachoroidal hemorrhage during pars plana vitrectomy. Curr Opin Ophthalmol 2001; 12(3): 179−85.

Ling R, Cole M, James C, Kamalarajah S, Foot B, Shaw S. Supra-choroidal haemorrhage complicating cataract surgery in the UK: epidemiology, clinical features, management, and out-comes. Br J Ophthalmol 2004; 88(4): 478−80.

Published
2015/07/08
Section
Case report