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    Violating ‘taboos’ to treat a suprachoroidal hemorrhage

    Operating sooner than recommended and removing cornea among ‘rules’ broken

    Take-home message: A group of surgeons were faced with a suprachoroidal hemorrhage following trauma, and decided to break the ‘rules’ when tackling the case, and came out with surprisingly good results.

     

    Ravenna, Italy—Operating only 7 days after trauma causing a suprachoroidal hemorrhage, surgeons at Domus Nova Hospital, Ravenna, Italy, were able to reconstruct the iris and cornea, as well as treat the hemorrhage and implant an IOL in a single procedure.

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    The 4-hour procedure violated more than one traditional “taboo” about treating this type of injury, said Matteo Forlini, MD.

    Dr. Forlini and his father (Cesare Folini, MD) collaborated in a presentation on a case study of the procedure. Not only did they operate sooner than is usually recommended, they only used 3 trocars—all in the pars plana—to achieve suprachoroidal hemorrhage drainage. Also contrary to textbook advice, they removed the cornea.

    The particular circumstances of the patient in this case necessitated these unusual steps, Dr. Forlini said.

    Breakdown of events prior to surgery

    Five years after receiving a cornea transplant, the 56-year-old man was in bed watching television. When he pulled the covers up, the remote control flew into his eye and hit the cornea at the site of the suture.

    “It was very unlucky,” said Dr. Forlini, adding they decided to operate quickly.

    Next: Examining the procedure

    Matteo Forlini, MD
    Matteo Forlini MD works at Santa Maria delle Croci Hospital in Ravenna, Italy.

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