Secondary management and outcome of massive suprachoroidal hemorrhage.
OBJECTIVE
To present the results of secondary surgical treatment of five patients with massive suprachoroidal hemorrhage (MSCH), which occurred intraoperatively, postoperatively, or following ocular trauma.


METHODS
Five patients presenting with MSCH were included in this study during or after phacoemulsification surgery (1 patient), glaucoma surgery (1 patient), combined glaucoma and phacoemulsification surgery (2 patients), and after traumatic sclera rupture (1 patient). Diagnosis was confirmed by ophthalmoscopy and B-scan ultrasonography. Pre-existing risk factors and distance visual acuity were documented. All cases received medical therapy and underwent secondary surgical intervention with radial sclerotomies combined with vitrectomy, use of perfluorocarbon, and silicone oil. Postoperative assessment included visual acuity measurement, ocular examination, and ultrasonography.


RESULTS
In all cases, anatomic restoration of ocular structures was achieved. Distance visual acuity improved in all cases (preoperative Snellen visual acuity ranged from light perception to hand motions; postoperative Snellen visual acuity ranged from 0.05 to 0.3). The mean follow-up period was 17 months.


CONCLUSIONS
In general, despite the advanced surgical techniques, the prognosis of MSCH remains guarded and the visual outcome poor. However, secondary surgical treatment with combined radial sclerotomies and vitrectomy should be considered in order to minimize the damaging effect and maximize the anatomic and functional restoration.
Feretis
E
E
Department of Ophthalmology, Red Cross Hospital, Athens, Greece.
Mourtzoukos
S
S
Mangouritsas
G
G
Kabanarou
S A
SA
Inoba
K
K
Xirou
T
T
D000368:Aged; D000369:Aged, 80 and over; D002832:Choroid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012599:Sclerostomy; D012827:Silicone Oils / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity; D014821:Vitrectomy
D012827:Silicone Oils