Suprachoroidal haemorrhage complicating cataract surgery in the UK: a case control study of risk factors

To study the risk factors for suprachoroidal haemorrhage (SCH) complicating cataract surgery in the United Kingdom.

109 cases of SCH complicating cataract surgery prospectively collected through the British Ophthalmological Surveillance Unit were compared with 449 controls that underwent cataract extraction from 13 "control centres" throughout UK in a case control study. 40 systemic, ophthalmic, and operative variables were examined.

Statistically significant risk factors for SCH in univariate analysis included: older age (p<0.001), taking at least one cardiovascular medication (p<0.001), peripheral vascular disease (p = 0.014), hyperlipidaemia (p = 0.005), glaucoma (p<0.001), elevated preoperative intraocular pressure (p<0.001), sub-Tenon's local anaesthesia (LA) (p<0.001), topical LA (p<0.001), the lack of orbital compression following LA (p<0.001), posterior capsule (PC) rupture before SCH (p<0.001), elective extracapsular cataract extraction (ECCE) (p = 0.038), and phacoemulsification conversion (p<0.001). Logistic regression analysis identified the following significant independent risk factors: older age, taking at least one cardiovascular medication, glaucoma, elevated preoperative intraocular pressure, the lack of orbital compression, PC rupture before SCH, elective ECCE, and phacoemulsification conversion.

The results allow identification of patients at risk of SCH. Attention to the various modifiable preoperative and intraoperative risk factors is recommended in order to minimise the risk of SCH.