Department of Ophthalmology, Hospital Costa del Sol, 29603 Marbella, Spain.
Department of Ophthalmology, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain.
Medicina (Kaunas). 2023 Mar 15;59(3):583. doi: 10.3390/medicina59030583.
Suprachoroidal hemorrhage (SCH) is a rare and sight-threatening complication of various intraocular surgeries, including cataract surgery. Although the rate of SCH complicating cataract surgery has decreased in the era of phacoemulsification, most likely due to smaller self-sealing incisions and modern equipment, it remains a challenging complication to manage. The aim of this review is to summarize the current evidence of the pathophysiology and management of SCH complicating phaco surgery. A literature review was performed using the PubMed database searching for diagnosis, therapy, and management of SCH during phacoemulsification. The evidence available on the optimal management of this condition is low, and there is no consensus so far. An early diagnosis is thought to be essential to avoid progression to the devastating stage of expulsion of intraocular contents (expulsive hemorrhage). Sudden intraoperative anterior chamber shallowing, red reflex loss, and a significant increase in intraocular pressure are highly suspicious for this severe complication. A fundus examination and ocular ultrasound are crucial to confirm the diagnosis and, if it is confirmed, stabilize the globe immediately. The initial therapeutic approach includes aggressive topical and systemic medication focused on controlling ocular inflammation and intraocular pressure, whereas the timing and the indications of surgical intervention remain controversial.
脉络膜上腔出血（SCH）是各种眼内手术的罕见且威胁视力的并发症，包括白内障手术。尽管在超声乳化时代，SCH 合并白内障手术的发生率已经降低，这很可能是由于切口更小的自封闭和现代设备的原因，但它仍然是一种具有挑战性的并发症。本综述旨在总结目前关于 SCH 合并白内障手术后的病理生理学和处理的证据。使用 PubMed 数据库进行文献回顾，搜索在超声乳化术中诊断、治疗和处理 SCH 的文献。对于这种情况的最佳治疗方法，目前的证据不足，也没有共识。早期诊断对于避免发展为眼内容物排出（逐出性出血）的破坏性阶段至关重要。术中前房突然变浅、红色反射消失和眼内压显著升高高度提示这种严重并发症。眼底检查和眼部超声检查对于明确诊断至关重要，如果确诊，应立即稳定眼球。初始治疗方法包括积极的局部和全身药物治疗，重点是控制眼内炎症和眼内压，而手术干预的时机和适应证仍存在争议。
