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

Jamali, Hossein; Sadeghi, Elham; Nowroozzadeh, Mohammad Hossein

doi:10.1002/ccr3.6204

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Finally, situations with increased episcleral pressure—including carotid cavernous fistulas, vitreous prolapse, liver failure, the maturity of the cataract, or even a recent COVID-19 infection—have also been suggested as risk factors for this condition. Interestingly, anticoagulation has not yet been proven to be a risk factor for ASCH [ 9 , 12 , 21 , 22 , 23 ].…”

Section: Pathophysiologymentioning

confidence: 99%

Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review

et al. 2023

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Suprachoroidal hemorrhage (SCH) is a rare and sight-threatening complication of various intraocular surgeries, including cataract surgery. Although the rate of SCH complicating cataract surgery has decreased in the era of phacoemulsification, most likely due to smaller self-sealing incisions and modern equipment, it remains a challenging complication to manage. The aim of this review is to summarize the current evidence of the pathophysiology and management of SCH complicating phaco surgery. A literature review was performed using the PubMed database searching for diagnosis, therapy, and management of SCH during phacoemulsification. The evidence available on the optimal management of this condition is low, and there is no consensus so far. An early diagnosis is thought to be essential to avoid progression to the devastating stage of expulsion of intraocular contents (expulsive hemorrhage). Sudden intraoperative anterior chamber shallowing, red reflex loss, and a significant increase in intraocular pressure are highly suspicious for this severe complication. A fundus examination and ocular ultrasound are crucial to confirm the diagnosis and, if it is confirmed, stabilize the globe immediately. The initial therapeutic approach includes aggressive topical and systemic medication focused on controlling ocular inflammation and intraocular pressure, whereas the timing and the indications of surgical intervention remain controversial.

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Section: Pathophysiologymentioning

confidence: 99%

Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review

et al. 2023

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“…SCH is also associated with new direct oral anticoagulants such as rivaroxaban and dabigatran, which are alternatives to vitamin K antagonists and heparin and used for thromboembolic diseases and stroke prevention in atrial fibrillation patients [37, 38]. COVID-19 infection or vaccination may be associated with SCH, which can be related to microvascular choroidal changes [39, 40].…”

Section: Spontaneous Schmentioning

confidence: 99%

“…Elevated episcleral vessel pressure in the carotid cavernous fistula, cataract maturity, posterior capsular rupture, vitreous loss, and recent COVID-19 infection may increase the risk of SCH during operation. There is no confirmation to recommend that anticoagulation is a risk factor for acute SCH in cataract surgeries [8, 40, 63]. Increased retro-orbital pressure after local anesthetic block can cause compression of the vortex veins, leading to impendence of flow, choroidal stasis, and subsequent hemorrhage [8].…”

Section: Surgery-related Schmentioning

confidence: 99%

“…On B scan, SCH typically shows dome-shaped choroidal detachment with multiple low reflective dot echoes behind the membrane suggestive of hemorrhage, in one or more quadrants, as shown in Figure 2. Corresponding A scan shows a double-peaked high reflective spike, i.e., M spike from the retina and choroid, behind which there are low reflective spikes suggestive of hemorrhage [40, 70]. When the CDs are highly elevated and touching each other, they are known as “kissing choroidals.” SCH needs to be differentiated from serous CDs, which typically are hypoechoic behind the membrane.…”

Section: Diagnosismentioning

confidence: 99%

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Suprachoroidal Hemorrhage

Mohan,

Sadeghi,

Mohan

et al. 2023

Ophthalmologica

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Suprachoroidal hemorrhage (SCH) refers to the accumulation of blood in the suprachoroidal space, a relatively uncommon but significant complication that can occur spontaneously, during ophthalmic surgery or as a consequence of ocular trauma. If left undiagnosed and untreated, SCH can lead to severe vision loss or even blindness. Therefore, it is crucial for ophthalmologists to have a thorough understanding of this complication, taking proactive measures to prevent it during surgery and being knowledgeable about effective management strategies for patients with SCH. This review article aims to provide a comprehensive overview of SCH, covering its risk factors, diagnostic approaches, and the best practices for its management. By enhancing awareness and knowledge in this area, we can improve patient outcomes and minimize the impact of SCH in ophthalmic practice.

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Perioperative suprachoroidal hemorrhage and its surgical management: a systematic review

Ribeiro,

Monteiro,

Moleiro

et al. 2024

Int J Retin Vitr

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Purpose Suprachoroidal hemorrhage (SCH) is a rare but severely feared sight-threatening complication of intraocular surgery, and its management remains debatable. We intended to summarize the existing surgical management options regarding perioperative SCH, describing different techniques and their respective visual outcomes. Methods A systematic literature search of articles published since 1st January 2011 until 31st December 2022 was performed using MEDLINE (PubMed) and Scopus. Eligibility criteria included the adult population with SCH related to intraocular surgery. Results Thirty-eight studies enrolling 393 patients/eyes were assessed after a selection process among 525 records. We included 5 retrospective cohort studies, 15 case series and 18 case reports. We documented cases of acute SCH diagnosed intraoperatively and delayed SCH, treated until a maximum of 120 days after the diagnosis. Best corrected visual acuity at diagnosis was generally poor, with variable final visual outcomes. Techniques of external drainage with or without combined pars plana vitrectomy (PPV), type of endotamponade (if PPV performed), anterior chamber maintainer and reports of the use of recombinant tissue plasminogen activator were described. Conclusion To the best of our knowledge, this is the first systematic review assessing perioperative SCH and its surgical management. There is no standardized surgical approach of SCH and longitudinal intervention studies are lacking. To ensure that patients achieve the best possible visual outcome, prompt diagnosis and treatment are crucial. Therefore, further clinical research is on demand to improve the management of this clinical sight-threatening entity.

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

Abstract: To report two cases of suprachoroidal hemorrhage during otherwise uncomplicated phacoemulsification, in whom COVID‐19 was documented with a positive PCR test about 1 month before the surgery and the importance of postponing elective surgeries for several months after infection.

Cited by 3 publications

References 10 publications

Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review

Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review

Suprachoroidal Hemorrhage

Perioperative suprachoroidal hemorrhage and its surgical management: a systematic review

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