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Acute intraoperative suprachoroidal haemorrhage in ocular surgery

Acute intraoperative suprachoroidal haemorrhage in ocular surgery
Acute intraoperative suprachoroidal haemorrhage in ocular surgery
PURPOSE/BACKGROUND: Acute intraoperative suprachoroidal haemorrhage (AISH) is the most sight-threatening complication of ocular surgery. We investigated the visual outcomes following this intraoperative event, patient characteristics that may predispose to it and the clinical features that may be of prognostic significance.

METHODS: The records of 45 cases of AISH collected from ophthalmic centres in the United Kingdom, Republic of Ireland and Switzerland were reviewed. Two satisfactory controls in terms of operative procedure, surgeon, age (+/- 5 years) and gender were found for each of 33 of our cases. Systemic and ocular characteristics were compared for cases and controls, and the visual results of all cases of AISH are analysed.

RESULTS: Cases and controls differed only in terms of axial length and pre-operative intraocular pressure, both of which were significantly greater for eyes that experienced an AISH (p < 0.05). Ten eyes (22.2%) achieved a final Snellen acuity of 6/12 or better. Statistically significant associations with a final acuity of counting fingers or worse included spontaneous nuclear expression (p = 0.02), retinal detachment (p < 0.0001), four-quadrant suprachoroidal haemorrhage (p = 0.007) and vision of perception of light or worse at the first dressing (p = 0.0001). Four of the 6 eyes that experienced an AISH during phacoemulsification surgery had a visual outcome of 6/12 or better, and this was significantly greater than for cases involving extracapsular cataract surgery (p = 0.004).

CONCLUSION: The results indicate that longer axial length and higher pre-operative intraocular pressure are associated with increased risk of AISH. Poor visual results are more likely following spontaneous nuclear expression, retinal detachment, four-quadrant suprachoroidal haemorrhage or vision of perception of light or worse at the first dressing. The results also suggest that AISH complicating a phacoemulsification procedure has a more favourable visual prognosis than AISH that occurs during extracapsular cataract surgery.
expulsive, haemorrhage, phacoemulsification, suprachoroidal
0950-222X
815-820
Beatty, S.
fe703588-1dfa-4820-834d-860b35fa03d3
Lotery, A.
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514
Kent, D.
8e204250-a02a-465e-bc9d-88d1ccde6bac
O'Driscoll, A.
a3341485-f2a2-4dac-9779-db22372f659d
Kilmartin, D.J.
4ef591cc-5dca-42e9-ab7e-0fdc7969e098
Wallace, D.
ba9a6075-3385-4541-adaf-4190f7dfb0d1
Baglivo, E.
405caf4a-edf1-4965-8c2d-0db467442929
Beatty, S.
fe703588-1dfa-4820-834d-860b35fa03d3
Lotery, A.
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514
Kent, D.
8e204250-a02a-465e-bc9d-88d1ccde6bac
O'Driscoll, A.
a3341485-f2a2-4dac-9779-db22372f659d
Kilmartin, D.J.
4ef591cc-5dca-42e9-ab7e-0fdc7969e098
Wallace, D.
ba9a6075-3385-4541-adaf-4190f7dfb0d1
Baglivo, E.
405caf4a-edf1-4965-8c2d-0db467442929

Beatty, S., Lotery, A., Kent, D., O'Driscoll, A., Kilmartin, D.J., Wallace, D. and Baglivo, E. (1998) Acute intraoperative suprachoroidal haemorrhage in ocular surgery. Eye, 12 (5), 815-820. (doi:10.1038/eye.1998.210). (PMID:10070516)

Record type: Article

Abstract

PURPOSE/BACKGROUND: Acute intraoperative suprachoroidal haemorrhage (AISH) is the most sight-threatening complication of ocular surgery. We investigated the visual outcomes following this intraoperative event, patient characteristics that may predispose to it and the clinical features that may be of prognostic significance.

METHODS: The records of 45 cases of AISH collected from ophthalmic centres in the United Kingdom, Republic of Ireland and Switzerland were reviewed. Two satisfactory controls in terms of operative procedure, surgeon, age (+/- 5 years) and gender were found for each of 33 of our cases. Systemic and ocular characteristics were compared for cases and controls, and the visual results of all cases of AISH are analysed.

RESULTS: Cases and controls differed only in terms of axial length and pre-operative intraocular pressure, both of which were significantly greater for eyes that experienced an AISH (p < 0.05). Ten eyes (22.2%) achieved a final Snellen acuity of 6/12 or better. Statistically significant associations with a final acuity of counting fingers or worse included spontaneous nuclear expression (p = 0.02), retinal detachment (p < 0.0001), four-quadrant suprachoroidal haemorrhage (p = 0.007) and vision of perception of light or worse at the first dressing (p = 0.0001). Four of the 6 eyes that experienced an AISH during phacoemulsification surgery had a visual outcome of 6/12 or better, and this was significantly greater than for cases involving extracapsular cataract surgery (p = 0.004).

CONCLUSION: The results indicate that longer axial length and higher pre-operative intraocular pressure are associated with increased risk of AISH. Poor visual results are more likely following spontaneous nuclear expression, retinal detachment, four-quadrant suprachoroidal haemorrhage or vision of perception of light or worse at the first dressing. The results also suggest that AISH complicating a phacoemulsification procedure has a more favourable visual prognosis than AISH that occurs during extracapsular cataract surgery.

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More information

Published date: September 1998
Keywords: expulsive, haemorrhage, phacoemulsification, suprachoroidal
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 359197
URI: https://eprints.soton.ac.uk/id/eprint/359197
ISSN: 0950-222X
PURE UUID: 54bc30bf-a731-4687-b82c-14bdc137e01f
ORCID for A. Lotery: ORCID iD orcid.org/0000-0001-5541-4305

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Date deposited: 06 Nov 2013 12:30
Last modified: 31 Jan 2019 01:36

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