The eye that developed suprachoroidal hemorrhage now has a poor prognosis (light perception vision). The contralateral eye has a significant cataract and needs phacoemulsification for the patient to be functional. What are the chances this contralateral eye will also develop a suprachoroidal hemorrhage during phacoemulsification?
It is important to ascertain the cause of the suprachoroidal hemorrhage (SCH) in the affected eye. If there are systemic factors like advanced age, uncontrolled hypertension, patient on antiplatelet medications, then there is always a risk of SCH developing in the other eye too. If it was caused due to intra-operative hypotony, then care should be taken to avoid hypotony during the surgery on the other eye.
Many parameters should be analyzed from the first surgery to assess the risk factors and causality of the SCH. Moreover, many risk factors exist, and should be assessed. They can be divided to :
- Systemic Risk factors, including Advanced age, Hypertension, Arteriosclerosis, Blood dyscrasia and Diabetes
- Ocular Risk Factors : Glaucoma, Myopia, Previous trauma or intraocular surgery, and SCH IN FELLOW EYE +++
- Peroperative Risk Factors : Peroperative Hypotony, Sudden lowering of IOP, valsalva maneuvers, complicated cataract surgery with vitreous loss, iris defects and uncontrolled maneuvers.
- Postoperative RF : Post Hypotony (wound leaking), Valsalva maneuvers...
One should recognize and assess all the previous factors, and prevent their occurring during the second surgery by sending the patient to an experimented surgeon, avoid preoperative anti platelets and anticoagulants, lowering IOP before surgery, Avoiding valsalva maneuvers and cataract surgery complications.
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