Posters

Intraoperative suprachoroidal hemorrhage during cataract surgery plus penetrating keratoplasty

Poster Details

First Author: C.Álvarez de Toledo Belil SPAIN

Co Author(s):    J. Fernández   J. Álvarez de Toledo                 

Abstract Details

Purpose:

To describe, step by step, how to manage succesfully an intraoperative suprachoroidal hemorrhage, including all the procedures and all the instruments which can be of great help to solve this fearsome complication.

Setting:

Centro de Oftalmología Barraquer

Methods:

We present the case of a 76-year-old patient with corneal leukoma with visual axis involvement as well as a white cataract. It was decided to perform the cataract extraction combined with penetrating keratoplasty. During surgery, a suprachoroidal hemorrhage occured, which was initially contained by performing manual compression and later with the expulsion lens, while two full-thickness sclerectomies are performed to drain the blood component. Finally, the graft is sutured with 16 10/0 Nylon stitches, leaving the sclerectomies open.

Results:

After surgery, B-Scan ultrasound control of the patient was performed, nasal and temporal hemorrhagic choroidal detachment (CD) was observed at 24 hours. It remained stable, however, after 72 hours, rebleeding occured, showing kissing choroidal detachment on ultrasound. It was decided to perform the drainage of the CD combined with pars plana vitrectomy and final exchange to silicone oil. After this second intervention, no CD was observed in the subsequent ultrasound controls.

Conclusions:

Suprachoroidal hemorrhage is an infrequent but fatal complication during cataract surgery or penetrating keratoplasty. Knowing the most effective surgical maneuvers, as well as the instruments available to the surgeon, can facilitate the management of this situation.

Financial Disclosure:

None