Expulsive Hemorrhage at Cataract Operation*

Clinical features, management, and outcomes of expulsive choroidal hemorrhage during cataract surgery: 13-year experience of a tertiary eye center

“…Ocular factors such as axial myopia, choroidal sclerosis, and glaucoma are associated with an increased risk for ECH. 23,24 Harder grades of cataract (51.9%) and glaucoma (38.5%) were the frequent ocular associations noted in our study, whereas age-related macular degeneration (53.1%) and glaucoma (9.4%) were the most frequent ocular associations reported in a literature review by Hsiao et al 6 Although extremes of axial length is a known risk factor for ECH, none of our patients were found to have this risk factor. 9,21…”

Expulsive Hemorrhage: Management Without Sclerotomy

“…We could find reports of only 17 cases in which useful vision was retained in spite of expulsive hemorrhage occurring during, or soon after cataract extraction f Vail, 1938;Duehr and Hogenson, 1947;Krasnov, 1959;Henderson, I960;Bair, 1966;Holland, 1966;Mackensen, 1966;Shaffer, 1966;Jaffe, 1972;Girard et al, 1973;Taylor, 1974], The accepted treatment of this condition is to evacuate the blood by the immediate per formance of sclerotomies in more than one quadrant, while the anterior chamber is closed and reformed with Ringer's solution. Anterior vitrectomy may be performed when the bleeding stops [Jaffe, 1972],…”

“…The incidence of expulsive hemorrhage during and following cataract extraction is about 0.2% [Taylor, 1974], Immediate evacuation of the hemorrhage through mul tiple sclerotomies has saved a few eyes with this condition [Vail, 1938;Duehr et at., 1947;Krasnov, 1959;Henderson, I960;Maekensen, 1966;Slwffer, 1966;Holland, 1966;Bair, 1966;Jaffe, 1972;Girard et al, 1973], but the prognosis is generally bad. The purpose of the present report is to dem onstrate that good vision may occasionally be retained without recourse to sclerotomy, and to point out that modern microsurgical techniques may not be ideal for the manage ment of this complication.…”