Delayed Suprachoroidal Hemorrhage After Pars Plana Vitrectomy: Five-Year Results of a Retrospective Multicenter Cohort Study.
OBJECTIVE
To determine the incidence, risk factors, and outcomes of delayed suprachoroidal hemorrhage after vitrectomy.


METHODS
Retrospective multicenter cohort study.


METHODS
All consecutive patients who underwent primary vitrectomy, from January 2009 to December 2014, at 4 tertiary vitreoretinal centers in Italy were enrolled. Patient demographics and systemic, ophthalmic, operative, and postoperative data from all centers were extracted from the electronic record system using standardized data collection forms. All eyes that developed delayed suprachoroidal hemorrhage within 48 hours of the end of the vitrectomy were identified as the delayed suprachoroidal hemorrhage group; all other eyes that underwent vitrectomy in the same period, without delayed suprachoroidal hemorrhage, were considered the control group.


RESULTS
From a total of 4852 vitrectomy procedures, 39 cases of delayed suprachoroidal hemorrhage (0.8%) were identified. Multivariable logistic regression showed that significant risk factors for developing delayed suprachoroidal hemorrhage included advancing age (odds ratio [OR], 2.22; P < .001), longer axial length (OR, 2.57; P < .001), presence of rhegmatogenous retinal detachment (OR, 3.27; P = .005), extensive intraoperative photocoagulation (OR, 4.94; P < .001), and emesis postoperatively (OR, 24.39; P < .001). Decision-tree analysis showed that the stronger predictors of delayed suprachoroidal hemorrhage were emesis postoperatively (P < .001) and extensive intraoperative photocoagulation (P < .001). After a mean follow-up of 27 ± 8 months, the best-corrected visual acuity decreased from 1.3 preoperatively to 1.6 logarithm of minimal angle of resolution at last follow-up (P < .001).


CONCLUSIONS
Delayed suprachoroidal hemorrhage occurs in 0.8% of vitrectomized eyes. The main risk factors are postoperative emesis and intraoperative extensive photocoagulation.
Department of Ophthalmology, University of Catania, Catania, Italy. Electronic address: mreibaldi@libero.it.
Michele
M
Reibaldi
Department of Ophthalmology, University of Catania, Catania, Italy.
Antonio
A
Longo
Department of Ophthalmology, Second University of Napoli, Napoli, Italy.
Mario R
MR
Romano
Department of Ophthalmology, Second University of Napoli, Napoli, Italy.
Gilda
G
Cennamo
Department of Ophthalmology, University of Ancona, Ancona, Italy.
Cesare
C
Mariotti
Department of Ophthalmology, University of Sassari, Sassari, Italy.
Francesco
F
Boscia
Department of Ophthalmology, University of Catania, Catania, Italy.
Vincenza
V
Bonfiglio
Department of Ophthalmology, University of Catania, Catania, Italy.
Teresio
T
Avitabile
D000368:Aged; D002832:Choroid Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D012163:Retinal Detachment / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014821:Vitrectomy / Q000009:adverse effects*