[Postoperative choroidal hemorrhage. Surgical indications].

PURPOSE: Through analysis of 18 cases of postoperative suprachoroidal haemorrhage, we discuss indications for surgical treatment, especially for vitrectomy. Time of surgery depends on complete lysis of the clot (mean of 7 days) determined by echography.

METHOD: Eighteen post-operative cases complicated with supra-choroidal hemorrhages were operated on between January 1988 and July 1992: 7 cases occurred after cataract extraction, 6 after filtering surgery and 5 after retinal detachment repair. Treatment, in all cases, included evacuation of the haematoma. A vitrectomy was associated in 14 cases using internal tamponade in 12 cases: 9 with silicone oil and 3 with SF6. The latest cases treated by vitrectomy benefited by the use of liquid perfluoro-carbons.

RESULTS: We had successful anatomical results in 14 eyes. For 12 eyes which kept functional vision, mean postoperative visual acuity was 20/100. We point out the high rate of secondary retinal detachment complicated by PVR (7 cases) and eventually responsible for treatment failure in 4 cases.

CONCLUSIONS: Satisfactory results can be obtained in treating post-operative choroidal haemorrage by appropriate use of vitrectomy: indications include incarceration of vitreous in the filtration bleb or in the cataract incision, vitreous haemorrhage, rhegmatogenous and/or traction retinal detachment. The echography is of great value to determine timing of surgery by assessing completeness of clot lysis.