Outcomes of suprachoroidal haemorrhage drainage with and without vitrectomy: a 10-year study

Abstract

Purpose The management of suprachoroidal haemorrhage (SCH) remains a challenge. We aimed to analyse and discuss the safety and efficacy outcomes of SCH drainage surgery over a 10-year period in one of the largest tertiary centres in the UK. Methods: Retrospective observational study of consecutive patients who underwent SCH drainage in Manchester Royal Eye Hospital over a 10-year period (from 2008 to 2018). Safety and efficacy were assessed by analysing surgery-related complications and functional and anatomical success. Outcomes of those who underwent external drainage alone versus combined drainage and vitrectomy were compared. Results: Twenty consecutive patients with a mean age of 70 ± 19 years were studied. Age over 70 years, hypertension, cardiovascular disease, and glaucoma were the most common risk factors for SCH. Eleven patients underwent external drainage alone and nine patients had combined vitrectomy and drainage. Overall, mean pre-operative BCVA improved from 2.22 ± 0.26 logMAR (20/3319 Snellen) to 1.42 ± 1.02 LogMAR (20/526 Snellen) at last follow-up visit (p = 0.002). Severe hypotony occurred in 4 patients. Overall anatomical and functional success rates were both 75%. Conclusions Drainage of SCH with or without vitrectomy is a valuable approach in the management of extensive SCH, a condition generally associated with poor prognosis.

Suprachoroidal hemorrhage during phacoemulsification surgery associated with recent COVID‐19: A report of two cases

“…This assumption is partly supported by the lack of known systemic or ocular risk factors of SCH in our patients and also their recent evident infection with COVID‐19. In the same setting, we had a rate of approximately 0.03% for intraoperative SCH during phacoemulsification in the pre‐COVID‐19 era (all in patients with known risk factors, systemic risk factors include old age and arteriosclerosis, coagulation disorders, vascular hypertension, diabetes mellitus, intraoperative tachycardia, and ocular risk factors include high myopia, glaucoma, previous vitrectomy, pseudophakia, and aphakia 9 ), further increasing our suspicion of COVID‐19 as a predisposing factor for SCH in patients mentioned above.…”

Outcomes in Patients with Suprachoroidal Hemorrhage After Anterior Segment Surgery

“…More recent retrospective studies performed at other institutions reported differences in their cohort composition, but had comparable findings to the current study. 24 Qureshi et al performed a retrospective analysis of 20 patients who underwent drainage with or without vitrectomy for SCH. 24 The most common cause of SCH within their cohort was phacoemulsification (35%, 7/20), and the series included 2 cases of traumatic SCH.…”

“… 24 Qureshi et al performed a retrospective analysis of 20 patients who underwent drainage with or without vitrectomy for SCH. 24 The most common cause of SCH within their cohort was phacoemulsification (35%, 7/20), and the series included 2 cases of traumatic SCH. External drainage alone was performed in 55% (11/20), while 45% (9/20) had combined PPV and drainage.…”

Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review

“…It has been reported that the majority of cases of phacoemulsification-related SCH tend to be limited; thus, medical management may be enough to achieve good visual outcomes [ 33 , 34 ]. Untreated SCH can lead to devastating consequences, including vision loss and phthisis bulbi [ 35 ]. Isolated cases of the spontaneous resolution of massive SCH with good visual outcomes have been reported; however, the prognosis of massive SCH is typically disappointing.…”