Glaucoma, heart disease among risk factors for suprachoroidal hemorrhage at cataract

Independent risk factors for suprachoroidal hemorrhage during cataract surgery include taking a cardiovascular medication, having glaucoma and undergoing extracapsular cataract extraction, researchers in the United Kingdom have found. Other independent risk factors identified included age, conversion to ECCE from phacoemulsification, elevated IOP preoperatively, lack of orbital compression following anesthesia and posterior capsular rupture during surgery.

R. Ling and colleagues prospectively collected 109 cases of suprachoroidal hemorrhage (SCH) complicating cataract surgery and compared them to 449 controls that underwent uncomplicated cataract extraction. Forty systemic, ophthalmic and operative variables were examined.

Statistically significant risk factors identified included older age, taking at least one cardiovascular medication, peripheral vascular disease, hyperlipidemia, glaucoma, elevated preoperative IOP, sub-Tenon’s local anesthesia, topical anesthesia, the lack of orbital compression following local anesthesia, posterior capsule rupture before SCH, elective extracapsular cataract extraction and phaco conversion.

The authors noted that their results allow the identification of patients at risk for SCH. They said consideration should be paid to modifiable preoperative and postoperative risk factors to help minimize the risk of SCH during cataract surgery.

The study is published in the April issue of British Journal of Ophthalmology.