Chai Fang, Ai Hua, Deng Jin, Zhao Xi-Quan
Xi'an No. 4 Hospital, Shaanxi Ophthalmic Medical Center, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
World J Clin Cases. 2018 Dec 6;6(15):1059-1066. doi: 10.12998/wjcc.v6.i15.1059.
Suprachoroidal hemorrhage (SCH) is a rare but potentially catastrophic ocular event. Surgery for SCH is often challenging because of the difficulty in resolving the retinal and choroidal detachment. Here, we describe a novel surgical technique in which urokinase is administered by sub-Tenon's injection to target an organized clot in SCH prior to drainage.
A consecutive case series of four eyes with serous and hemorrhagic choroidal detachments secondary to cataract surgery or trauma was documented to evaluate the feasibility of using a sub-Tenon's urokinase injection-assisted 23-gauge and 20-gauge incision to drain choroidal detachments. Urokinase (2000 IU) was given by sub-Tenon's injection one day before surgery for clot liquefaction. A 23-gauge infusion line was placed in the anterior chamber. A 20-gauge incision was created in the suprachoroidal space 3.5 mm from the limbus. After drainage, pars plana vitrectomy was performed because of concomitant pathology that demanded this additional procedure. Visual acuity, ocular findings, the timing of surgical interventions, surgical procedures, and outcomes were retrospectively reviewed in four patients. Postoperative follow-up of the patients ranged from 6 to 24 mo (mean, 13 mo). After the treatment, all patients achieved excellent anatomical recovery.
Sub-Tenon's urokinase injection-assisted vitrectomy makes clot liquefaction happen in the early treatment stage, resulting in marked stability during the procedure.
脉络膜上腔出血（SCH）是一种罕见但可能具有灾难性的眼部事件。由于难以解决视网膜和脉络膜脱离问题，SCH的手术往往具有挑战性。在此，我们描述一种新的手术技术，即在引流前通过球后注射尿激酶靶向SCH中的机化血块。
记录了一组连续4例因白内障手术或外伤继发浆液性和出血性脉络膜脱离的病例，以评估使用球后注射尿激酶辅助的23G和20G切口引流脉络膜脱离的可行性。术前一天通过球后注射尿激酶（2000 IU）以使血块液化。在前房置入一条23G输液管。在距角膜缘3.5 mm处的脉络膜上腔做一个20G切口。引流后，由于存在需要额外手术的合并病变，进行了玻璃体切除术。对4例患者的视力、眼部检查结果、手术干预时机、手术过程及预后进行了回顾性分析。患者术后随访时间为6至24个月（平均13个月）。治疗后，所有患者均实现了良好的解剖学恢复。
球后注射尿激酶辅助玻璃体切除术可在治疗早期实现血块液化，从而在手术过程中显著提高稳定性。
