[Postoperative choroidal hemorrhage. Surgical indications].

PURPOSE

Through analysis of 18 cases of postoperative suprachoroidal haemorrhage, we discuss indications for surgical treatment, especially for vitrectomy. Time of surgery depends on complete lysis of the clot (mean of 7 days) determined by echography.

METHOD

Eighteen post-operative cases complicated with supra-choroidal hemorrhages were operated on between January 1988 and July 1992: 7 cases occurred after cataract extraction, 6 after filtering surgery and 5 after retinal detachment repair. Treatment, in all cases, included evacuation of the haematoma. A vitrectomy was associated in 14 cases using internal tamponade in 12 cases: 9 with silicone oil and 3 with SF6. The latest cases treated by vitrectomy benefited by the use of liquid perfluoro-carbons.

RESULTS

We had successful anatomical results in 14 eyes. For 12 eyes which kept functional vision, mean postoperative visual acuity was 20/100. We point out the high rate of secondary retinal detachment complicated by PVR (7 cases) and eventually responsible for treatment failure in 4 cases.

CONCLUSIONS

Satisfactory results can be obtained in treating post-operative choroidal haemorrage by appropriate use of vitrectomy: indications include incarceration of vitreous in the filtration bleb or in the cataract incision, vitreous haemorrhage, rhegmatogenous and/or traction retinal detachment. The echography is of great value to determine timing of surgery by assessing completeness of clot lysis.