This was a retrospective, case-controlled study of patients that underwent glaucoma surgery over a 10-year period at a single tertiary referral eye hospital to determine the incidence, risk factors and outcomes of delayed suprachoroidal hemorrhage (DSCH).
Of the 2,752 glaucoma surgeries performed during the 10-year study period, 29 cases of DSCH were identified (1 percent). They observed a significantly increased incidence of DSCH after drainage device implantation compared with trabeculectomy.
Other statistically significant risk factors for DSCH: IOP of 3 mmHg or less within one week after surgery, aphakia, prior intraocular surgery, hypertension, preoperative use of anticoagulation therapy, ischemic heart disease, and respiratory disease were. The visual outcome of patients with hemorrhage was poor and was significantly worse when compared with the control group.
In this article Jegenathan et al, describe the risk factors for suprachoroidal hemorrhage, a dreaded and devastating complication of glaucoma surgery. Though many of the risk factors identified in this paper have been described previously in other series, it is important to realize that the risk of hemorrhage was greater with glaucoma drainage devices than trabeculectomies.
It was also interesting to note that postoperative hypotony was also identified as a risk factor. Identification of these additional risk factors must be taken into consideration by the glaucoma surgeon in preoperative planning, in the informed consent process and in postoperative care.
Dr. Edwards has no financial interests to disclose.