Use of PPV (23G) in a 55-year-old patient with high myopia 23 days after phacoemulsification complicated by suprachoroidal hemorrhage

Abstract Introduction Suprachoroidal hemorrhage (SCH) is a severe complication that can arise both during and after ophthalmic procedures. The occurrence rate during cataract phacoemulsification surgery ranges from 0.03% to 0.13%. This condition is caused by damage to the posterior long or short ciliary artery, leading to blood accumulation in the area between the choroid and sclera. Risk factors for SCH include intraocular surgeries, older age, glaucoma, and myopia. Materials and Methods A 55-year-old female patient presented to the Ophthalmology Outpatient Clinic with SCH and hemorrhagic retinal detachment of the left eye (OS) resulting from phacoemulsification cataract surgery with high degenerative myopia. The visual acuity (VA) of the OS before vitrectomy (PPV) was at 0.001, and the intraocular pressure (IOP) in the OS was 20 mmHg. After the additional examinations, the patient was qualified for PPV. PPV was performed from a posterior access, mAndo iridotomy, decalin was administered, subretinal and subconjunctival blood was partially evacuated, retinal endolaser was performed, decalin was removed, and OS silicone oil endotamponade was performed. Results At the first follow-up 7 days after PPV, the VA of the OS was 0.06, and the IOP value in the OS was 14 mmHg. B-projection ultrasound showed dense silicone oil echoes, and the retina appeared adherent. At follow-up after 1 and 3 months, VA was at 0.1 and 0.7 respectively, and IOP in the OS was 14 mmHg. Conclusions Despite the difficulties associated with high myopia and extensive SCH, the PPV procedure proved to be extremely effective for achieving satisfactory visual acuity and restoring correct anatomical conditions.