Abstract General Information

Título/Title

CHOROIDAL STORM

Resumo/Abstracts

A 74 years old female patient underwent vitrectomy due to entire and hard cataract dislocated into the vitreous cavity.
The procedure involved the use of a 20-gauge fragmatome.
As the patient had capsular support, the placement of an intraocular lens (IOL) in the ciliary sulcus was chosen.
However, the patient experienced intense agitation with abrupt head movements and loss of the red reflex was observed.
Upon identification of the suprachoroidal hemorrhage, the infusion was closed. A trocar was positioned in the suprachoroidal space and the valve was compressed. The infusion was changed to a superior trocar, the IOL was explanted, and to prevent an expulsive complication corneal suturing was promptly performed.
In the postoperative, the patient presented with decreased visual acuity, hemorrhagic choroidal detachment and elevated IOP.
12 days after the initial surgery, the patient underwent a second procedure for drainage.
Initially, transconjunctival drainage was attempted using a 23-gauge trocar. Subsequently, sclerotomy enlargement was performed, along with maneuvers to displace the hemorrhage and remove clots using an iris spatula.
The patient exhibited persistent but minor hemorrhage, which completely regressed after 30 days.
Patient presented complete resolution of supracoroidal hemorrhage
The resolve the aphakia and remaining hemorrhage in the vitreous cavity, a new vitrectomy was performed. During the procedure, the retina was observed to be attached, with persistent folds as a consequence of the extensive choroidal detachment. Due to the presence of capsular support, an IOL was implanted in the ciliary sulcus.
Postoperatively, the patient exhibited persistent retinal folds, but with significant improvement in visual acuity.