SCIENTIFIC REPORT

Suprachoroidal haemorrhage complicating cataract surgery in the UK: epidemiology, clinical features, management, and outcomes

R Ling¹, M Cole¹, C James¹, S Kamalarajah², B Foot³ and S Shaw⁴

¹ Department of Ophthalmology, Torbay Hospital, Torquay, UK
² Eye and Ear Clinic, Royal Victoria Hospital, Belfast, UK
³ The British Ophthalmological Surveillance Unit, The Royal College of Ophthalmologists, UK
⁴ Department of Mathematics & Statistics, University of Plymouth, UK

Correspondence to:
Correspondence to:
MrR Ling
Consultant Ophthalmologist, West of England Eye Unit, Royal Devon & Exeter Hospital (Wonford), Barrack Road, Exeter EX2 5DW, UK; roland.ling{at}rdehc-tr.swest.nhs.uk

Aims: To study the incidence, management, and outcomes of suprachoroidal haemorrhage (SCH) complicating cataract surgery in the United Kingdom.

Methods: Cases were prospectively collected by active surveillance through the British Ophthalmological Surveillance Unit. Details were obtained using an incident questionnaire with follow up at 6 months.

Results: 118 cases were reported in 1 year. The estimated incidence of SCH was 0.04% (95% confidence interval 0.034% to 0.050%). Cataract extractions were by phacoemulsification in 76.2%, extracapsular cataract extraction (ECCE) in 11.0%, and phacoemulsification conversion in 12.8%. SCH was "limited" (1 to 2 quadrants) in 48.7%, "full blown" (3 to 4 quadrants) in 43.1%. SCH in phacoemulsification was more likely to be limited (63.2%), compared with ECCE (11.1%) and phacoemulsification conversion (23.1%) (p<0.001, ² test). Visual acuity (VA) was better than 6/60 in 57 of 95 (60%) cases after a median follow up interval of 185 days. 33 of 34 cases (97.1%) with secondary anterior segment revision had VA better than 6/60. VA was worse than 6/60 in 7 of 8 (87.5%) cases that had intraoperative sclerostomy, and in all 6 (100%) cases that had secondary posterior segment intervention.

Conclusion: SCH is a rare but serious complication of cataract surgery. Poor prognostic factors included full blown SCH, ECCE, phacoemulsification conversion, retinal apposition, and retinal detachment.

Keywords: suprachoroidal haemorrhage; cataract surgery; epidemiology; outcomes

Abbreviations: BOSU, British Ophthalmological Surveillance Unit; ECCE, extracapsular technique; SCH, suprachoroidal haemorrhage; VA, visual acuity

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