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3 different approaches to management of suprachoroidal haemorrhage during cataract surgery

Poster Details

First Author: M.Jeffries UK

Co Author(s):    C. Hugkulstone   L. Whitefield           

Abstract Details



Purpose:

Suprachoroidal haemorrhage is a potentially devastating complication of routine cataract surgery. The incidence is quoted as 0.1% and clinically there is iris prolapse, loss of vitreous with raised intraocular pressure and loss/ darkening of the red reflex. The patient will complain of severe pain. It is postulated that the pathophysiology of suprachoroidal haemorrhage is as follows- hypotony leads to increased choroidal transmural venous pressure resulting in a serous effusion within the suprachoroidal space. As this accumulates the short and long posterior ciliary vessels that traverse the suprachoroidal space become stretched and suprachoroidal haemorrhage occurs when these vessels rupture from excessive stretching. Herein we compare the acute and subsequent management of three cases of suprachoroidal haemorrhage during routine cataract surgery.

Setting:

Three cases of suprachoroidal haemorrhage occurred during routine phacoemulsification cataract surgery a district general hospital in Kent. The surgery was performed by two highly experienced senior consultant cataract surgeons.

Methods:

Three cases of intraoperative suprachoroidal haemorrhages were managed differently in the acute setting. A review of each case and subsequent clinical outcomes is made herein.

Results:

Preoperatively all three cases were considered routine. None were warfarinised. The average age was 71 (range 62-81). One patient was a well controlled hypertensive. In all three cases the suprachoroidal haemorrhage was noted at the irrigation and aspiration stage. 2 patients achieved a post operative visual acuity of 6/6. The third achieved 6/18.

Conclusions:

Suprachoroidal haemorrhages are a rare but potentially devastating complication of phacoemulsification cataract surgery. We describe three approaches in the acute setting as well as the subsequent management and clinical outcomes. FINANCIAL INTEREST: NONE

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