Acute intraoperative suprachoroidal hemorrhage in capsular bag phacoemulsification

Two cases of limited (nonexpulsive) acute intraoperative suprachoroidal hemorrhage (AISH) were identified in a consecutive series of 3,096 cataract surgeries accomplished by capsular bag phacoemulsification--an incidence of 0.06%. This is lower than that reported by me in 1986 when I was using iris plane phacoemulsification (0.81%). I believe the reduction is the result of decreased anatomical distortion from reducing the number and amplitude of intraocular pressure swings experienced by the globe during surgery. The pressure swings result from technique-mandated oscillations in infusion and aspiration dynamics, which are greater in number and amplitude in the iris plane technique.