Long-term prognosis of eyes having had operative suprachoroidal expulsive hemorrhage

We reviewed the charts of 15 patients having had an operative suprachoroidal expulsive hemorrhage (SEH) at least 5 years prior to the time of review. In all cases the eyes were glaucomatous. All SEH occurred in close association with the surgery, with 14 cases occurring at the time of surgery and 1 case developing within 2 days of the procedure. Three eyes were markedly worse following the SEH, losing six or more lines of vision; in all cases this loss was due to retinal detachment. In a fourth eye in which a retinal detachment occurred postoperatively, fair acuity (20/100) was preserved. The other 11 eyes not having retinal detachment had no further complications, though 6 eyes eventually lost acuity during the next 5-15 years; this loss was due to progressive glaucoma and/or macular degenerative change and did not appear to be a function of damage related to the SEH itself. Two eyes subsequently had uncomplicated cataract extraction resulting in visual improvement. When an SEH neither causes immediate loss of choroid or retina nor is associated with postoperative retinal detachment, the SEH itself may not damage the long-term clinical course of the affected eye.