Simplified Transconjunctival Approach to Draining Suprachoroidal Hemorrhage

In this video, Dr. Rahul Komati and his colleagues demonstrate a transconjunctival, sutureless approach to drain hemorrhagic choroidals using standard 3-port vitrectomy instrumentation. This 69-year-old patient developed hypotony and a painful suprachoroidal hemorrhage 1 day after trabeculectomy revision. The surgeons inserted a pair of 23-gauge nonvalved cannulas in the pars plana and identified the quadrant with the largest choroidals (nasal, in this case) to initiate drainage. When inserting the third trocar, it is important to have shallow entry to avoid piercing the retina. After evacuating blood and clots, the cannula can be repositioned in other quadrants (inferotemporal, in this case) to find additional pockets to drain. Once the choroidals are adequately reduced, vitrectomy can be carried out to identify and address any pathology. In this case, the retina was found to be attached and healthy. Vision improved from light perception to 20/100 after surgery.

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