Suprachoroidal hemorrhage during pars plana vitrectomy in traumatized eyes.

BACKGROUND: Suprachoroidal hemorrhage (SCH) is a rare but dangerous complication of intraocular surgery. There are some risk factors for this devastating complication during pars plana vitrectomy. In this case, we will report the intraoperative occurrence of SCH during pars plana vitrectomy in traumatized eyes.

METHODS: Retrospective analysis of SCH during pars plana vitrectomy in five eyes with the history of blunt (n = 1) or penetrating (n = 4) trauma was made. Baseline systemic and ocular characteristics, surgical procedures, time point of SCH, management of SCH, and final visual outcomes were measured.

RESULTS: One eye with associated myopia developed SCH during the time of producing vitreous posterior detachment under ocular hypotony. In other two eyes, SCH developed under ocular hypotony during fluid-gas exchange. The remaining two eyes got SCH when the depression of the area of pars plana occurred. Sclerotomy closure was performed immediately once SCH occurred. Vitrectomy and posterior sclerotomy were then performed between 8 and 12 days later. After a median follow-up of 12 months (range: 3-20 months), final visual acuity was above 20/400 in four eyes, no light perception in one eye, the best visual acuity was 20/60.

CONCLUSIONS: Ocular trauma is one of the vital risk factors for the development of intraoperative SCH during pars plana vitrectomy. It is important to control effectively the intraocular inflammation preoperatively and avoid abrupt ocular hypotony and pressure on the area of pars plana intraoperatively to the limit.