Cases reported "Choroid Hemorrhage"

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1/6. Acute suprachoroidal hemorrhage during phacoemulsification.

    We present a case of acute suprachoroidal hemorrhage that developed during routine phacoemulsification in an 85-year-old patient after uneventful administration of periocular anesthesia. Pre-existing risk factors included advanced age, glaucoma, myopia, and hypertension. The scleral tunnel prevented major expulsion of intraocular contents; however, raised intraocular pressure prevented intraocular lens implantation. The rarity of this condition raises questions regarding the further management and precautions related to it.
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ranking = 1
keywords = phacoemulsification
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2/6. Intraoperative choroidal hemorrhage in the Osler-Rendu-Weber syndrome.

    PURPOSE: To describe a patient with Osler-Rendu-Weber syndrome who developed a nonsimultaneous intraoperative choroidal hemorrhage in each eye. METHOD: Interventional case report. A 65-year-old Caucasian woman with Osler-Rendu-Weber syndrome developed a choroidal hemorrhage in the left eye during vitrectomy for a complicated retinal detachment with a poor visual outcome. Fifteen years later, she developed a macula on retinal detachment in the right eye, which also had a dense cataract. Immediately after uncomplicated phacoemulsification and intraocular lens implantation, under monitored anesthesia care and retrobulbar block, and without valsalva stress, ophthalmoscopy demonstrated a choroidal hemorrhage. A planned scleral buckle was replaced by pneumatic retinopexy. RESULTS: Seven months postoperatively, the retina remained attached with resolution of the choroidal hemorrhage. visual acuity was 20/30.CONCLUSION: Choroidal hemorrhage may occur more commonly in individuals with Osler-Rendu-Weber syndrome. Recognition of this possible association and institution of appropriate intraoperative precautions may facilitate a good visual outcome.
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ranking = 0.2
keywords = phacoemulsification
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3/6. Expulsive hemorrhage before phacoemulsification.

    A 65-year-old white man who was scheduled for cataract extraction experienced a sudden increase in intraocular pressure (IOP) with flattening of the anterior chamber immediately after the anterior capsule incision. The eye was sutured, and because no decrease in pressure was noted, surgery was postponed. The presence of the cataract prevented ophthalmoscopic examination. Echographic examination revealed a hemorrhagic choroidal detachment with involvement of the ciliary body. The patient was examined regularly until the choroidal detachment disappeared 4 weeks later. He then had uneventful phacoemulsification and intraocular lens implantation.
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ranking = 1
keywords = phacoemulsification
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4/6. Acute suprachoroidal hemorrhage during clear corneal phacoemulsification using topical and intracameral anesthesia.

    Shallowing of the anterior chamber and hardening of the eye occurred just before commencement of irrigation/aspiration of cortex in an 80-year-old man having temporal clear corneal cataract surgery under topical and intracameral anesthesia. Nucleus removal had been completed and was uneventful. Intraoperative fundus examination with the indirect ophthalmoscope disclosed a choroidal hemorrhage. The wound was immediately closed with sutures, and intravenous mannitol was administered. The hemorrhage remained localized. The red reflex remained unchanged at all times, and there was no prolapse of intraocular contents. A high index of suspicion is critical to the early diagnosis and management of choroidal hemorrhage.
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ranking = 0.8
keywords = phacoemulsification
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5/6. Acute intraoperative suprachoroidal hemorrhage in extracapsular cataract surgery.

    The incidence of acute intraoperative suprachoroidal hemorrhage (AISH) was studied in 2,839 consecutive extracapsular cataract extraction cases operated by nucleus expression and phacoemulsification. Twenty-five eyes (0.9%) were identified with this complication. Acute intraoperative suprachoroidal hemorrhage was defined as the acute accumulation of fluid in the suprachoroidal space which resulted from a presumed suprachoroidal hemorrhage at the time of surgery. Preoperative risk factors for the development of this complication included advanced age and the presence of glaucoma. sex, controlled hypertension, long axial length, and method of cataract removal could not be identified as significant risk factors. Recognition of the early signs of AISH and initiation of rapid wound closure followed by the completion of secondary operations performed the next day helped to meet the surgical objective and to provide excellent visual results, with 21 eyes (84%) having a visual acuity of 20/30 or better.
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ranking = 0.2
keywords = phacoemulsification
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6/6. Acute intraoperative suprachoroidal hemorrhage in capsular bag phacoemulsification.

    Two cases of limited (nonexpulsive) acute intraoperative suprachoroidal hemorrhage (AISH) were identified in a consecutive series of 3,096 cataract surgeries accomplished by capsular bag phacoemulsification--an incidence of 0.06%. This is lower than that reported by me in 1986 when I was using iris plane phacoemulsification (0.81%). I believe the reduction is the result of decreased anatomical distortion from reducing the number and amplitude of intraocular pressure swings experienced by the globe during surgery. The pressure swings result from technique-mandated oscillations in infusion and aspiration dynamics, which are greater in number and amplitude in the iris plane technique.
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ranking = 1.2
keywords = phacoemulsification
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