Management of delayed massive suprachoroidal hemorrhage: a clinical retrospective study

Suprachoroidal hemorrhages, both expulsive and delayed non-expulsive, are among the most devastating complications of intraocular surgery. We reviewed the charts of 13 patients with a delayed non-expulsive suprachoroidal hemorrhage (DNSCH) after cataract extraction (3 patients), glaucoma filtering surgery (6 patients), penetrating keratoplasty (3 patients), or vitrectomy (1 patient). All had large hemorrhagic choroidal detachments with nine eyes presenting kissing choroidal detachment, five eyes with associated retinal detachment, and one eye with intravitreous hemorrhage. All patients were treated with systemic corticosteroids before surgery. Eleven eyes underwent anterior drainage sclerotomy, followed by SF6 gas injection in eight eyes, and pars plana vitrectomy with silicon oil tamponade in three eyes. Mean follow-up was 22 months. These procedures gave good anatomical results in eleven cases and good visual results in nine. The results suggest that not all DNSCH need to be drained surgically but that, when surgical drainage is indicated, the use of gas to maintain internal tamponade appears to be beneficial.