By Brian Little, FRCS, FRCOphth
    Video Journal of Cataract and Refractive Surgery
    Cataract/Anterior Segment

    In this video from Dr. Osher's Video Journal of Cataract and Refractive Surgery, Brian Little presents two cases of suprachoroidal hemorrhage that illustrate the importance of early recognition and action.

    In the first case, the surgeon ignores warning signs such as a bulging posterior capsule and subtle reflex of viscoelastic, and then attempts to complete the surgery despite spontaneous shallowing of the chamber and uncontrollable iris prolapse. The eye suffers an extensive, expulsive suprachoroidal hemorrhage. At the conclusion of the case, the patient's vision is limited to vague light perception.

    In the second case, which begins uneventfully as the first, the surgeon recognizes the problem at the periphery of the eye, withdraws all instruments and confirms the presence of early suprachoridal hemorrhage. The surgery is stopped and an endocapsular IOL implantation is completed successfully two weeks later.

    The author emphasizes that in all cases of suspected suprachoroidal hemorrhage, the best course is to remove all instruments from the eye, close wounds, and defer the procedure.