ACUTE INTRAOPERATIVE SUPRACHOROIDAL HEMORRHAGE DURING SMALL-GAUGE PARS PLANA VITRECTOMY. (2018)

• Record Type: Journal Article
• Authors: Sukpen, Intira; Stewart, Jay M.
• Is Part Of: Retinal cases & brief reports. Volume 12(2018)Supplement 1
• Publication Date: 2018
• Subjects: intraoperative suprachoroidal hemorrhage -- small-gauge pars plana vitrectomy; Retina -- Diseases -- Periodicals; Retina -- Periodicals; Retinal Diseases -- Periodicals; Retina -- Case Reports; Retinal Diseases -- Case Reports; 617.7
• DOI: 10.1097/ICB.0000000000000659
• Languages: English
• ISSNs: 1935-1089

Abstract

Abstract : Purpose: To report the intraoperative occurrence of acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy. Method: A review of a surgical patient who developed acute intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia. Results: A 32-year-old obese woman with proliferative diabetic retinopathy and traction retinal detachment in the left eye who developed intraoperative suprachoroidal hemorrhage during small-gauge pars plana vitrectomy because of bucking under general anesthesia while doing endolaser under air infusion. The pressure was immediately elevated to stabilize the hemorrhage without sclerotomy creation, and then gas (14% C3 F8 ) was injected, with subsequent face-down positioning. The patient subsequently developed proliferative vitreoretinopathy, requiring additional surgery. The final visual acuity at 14-month follow-up was hand motions with a reattached retina in the left eye. Conclusion: Valsalva-induced suprachoroidal hemorrhage during pars plana vitrectomy under general anesthesia may result in sight-threatening visual consequences. Current small-gauge vitrectomy techniques using valved cannulas may allow for better intraoperative management of this complication through control of the intraocular pressure in a closed system. Abstract : A patient was undergoing vitrectomy surgery with general anesthesia for repair of diabetic traction retinal detachment and suddenly started to "buck" on the breathing tube, resulting in suprachoroidal hemorrhage. Small-gauge vitrectomy systems with valved cannulas may offer improved control of this complication by providing a means of stabilizing intraocular pressure.