Delayed Suprachoroidal Hemorrhage
For a discussion of intraoperative suprachoroidal hemorrhage, please see Chapter 10. Delayed suprachoroidal hemorrhage may occur in the early postoperative period, presenting with sudden onset of pain, loss of vision, and shallowing of the anterior chamber. Predisposing factors for postoperative choroidal hemorrhage or effusion include prolonged hypotony, wound leak, unrecognized scleral perforation, trauma, uveitis, cyclodialysis, and excessive filtration. This condition is far more common after glaucoma filtering procedures than routine cataract surgery and may also arise after laser photocoagulation or cryotherapy.
When an incision remains intact and the IOP can be controlled medically, limited suprachoroidal hemorrhage may be observed and frequently will resolve spontaneously. If the incision is not intact, surgical revision may be sufficient to allow the hemorrhage to resolve. Medical management consists of systemic corticosteroids, topical and oral ocular hypotensive agents for elevated IOP, topical cycloplegia, and close observation. Surgical drainage of the suprachoroidal space is indicated when there is a flat anterior chamber, medically uncontrolled glaucoma, or persistent or adherent (kissing) choroidal detachments.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.