How to handle ocular hemorrhage during corneal procedures
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WAIKOLOA, Hawaii — When it comes to the intraoperative management of ocular hemorrhage during DMEK or other corneal surgeries the most important first step is not to panic, a presenter said here in a case presentation.
At Hawaiian Eye 2022, Audrey R. Talley Rostov, MD, shared cases of ocular hemorrhage that occurred during a cornela surgery she was performing to share some pearls on how she managed the cases.
The first key, she said, is not to panic and to locate the source. “It could be from the PI, the iris or the wound.”
If possible, maintain the safety of the graft. In one case she showed she was able to remove the graft before it was contaminated, and she worked to stop the bleeding.
If the graft is already in the eye, inject air to help tamponade.
“For me, BSS and air have been my friends in these cases,” Rostov explained. “If you do enough surgery things happen and it's how you handle the complications.”
“If you get the air in the right place so that your graft is adhered, then that's lucky,” she said. “If not, then to find and remove the graft is probably your best bet.”
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Rostov A, et al. Medical and surgical cornea: Case presentations. Presented at: Hawaiian Eye; Jan. 15-21, 2022; Waikoloa, Hawaii.
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