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Outcome of vitrectomy for suprachoroideal hemorrhage

Session Details

Session Title: Quick Fire Free Paper 1

Session Date/Time: Thursday 11/09/2014 | 08:00-10:00

Paper Time: 09:00

Venue: Boulevard D

First Author: : J.G.Garweg SWITZERLAND

Co Author(s): :    M. Halberstadt              

Abstract Details

Purpose:

Suprachoroideal hemorrhage leading to kissing choroids and eventually extrusion of intraocular tissues is a rare complication of intraocular surgery with an incidence of 0.04% in cataract surgery, 0.15% in trabeculectomy, 0.41% after vitrectomy, and 0.45% in penetrating keratoplasty. Etiologically, a low intraocular pressure presumably induces intercellular effusion primarily into the choroid, expanding secondarily into the suprachoroideal space. The separation of the choroid from the underlaying sclera results in rupture of posterio ciliary vessels in predisposed patients with usually poor to very poor functional outcomes. Herein, we present the results of an own series treated during the last 18 years.

Setting:

Consecutive case series operated by a single surgeon (JGG) at the department Ophthalmology, University of Bern, and Berner Augenklinik am Lindenhofspital, Swiss Eye Institute

Methods:

From 45 consecutive patients referred for vitrectomy after suprachoroideal hemorrhage, demographic data and risk factors were documented. The clinical outcome after a follow up of minimally 6 months after last surgery was documented for 36 of them.

Results:

After an average of 2.6 surgeries per eye, two eyes had been enucleated, five achieved light perception only, another 14 eyes peripheral vision (VA <10/200). 12 eyes had a final visual acuity above 10/200, 3 eyes 10/20 or better. Hypotony was present in 12 patients, IOP between 8 -20mmHg in 21 patients and medically not sufficiently controled IOP in 1 eye.

Conclusions:

Modern microsurgical treatment of this unfavourable situation resulted in a useful visual function (>20/200) in 32% of eyes and absence of complaints in 89% which exceeds the outcomes of published series. These results justify the attempt for a surgical restoration of vision in the majority of cases in this situation.

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