Postoperative suprachoroidal hemorrhage following filtration procedures
J. M. Ruderman, T. S. Harbin Jr and D. G. Campbell
We reviewed the charts of 500 patients who underwent filtration procedures
and found ten patients who developed postoperative suprachoroidal
hemorrhage (PSCH) following surgery. The incidence (2% overall) is
especially high in those patients who were aphakic (6.6%) or who had high
myopia (10%). Nine patients developed PSCH within the first four
postoperative days. Pain, nausea, and vomiting were common presenting
symptoms of PSCH although not invariably present. Postoperative
suprachoroidal hemorrhage is related to prolonged hypotonia and
inflammation; prevention centers on proper case selection and on avoiding a
precipitous rise in postoperative intravascular pressure. Initial treatment
consisted of anterior chamber reformation and drainage of suprachoroidal
blood, often followed by vitrectomy and scleral buckling procedures. Four
eyes (40%) obtained final visual acuities of 20/200 or better, four (40%)
were reduced to counting fingers or hand motions, and two (20%) lost all
light perception.
