内眼手术中脉络膜上腔出血

Intraocular surgery and suprachoroidal hemorrhage

为探讨内眼手术中脉络膜上腔出血的临床特点及手术治疗与预后的关系，对１３例脉络膜上腔出血进行了回顾性分析。临床检查和Ｂ超显示：全部病例都有玻璃体出血，大部分病例有环周脉络膜上腔出血和前房出血而无视网膜脱离。４例做了后巩膜切开引流术，４例做了玻璃体视网膜手术，结果３例视力为０．０５～０．１２，１例为手动，其余均完全失明。表明内眼手术中脉络膜上腔出血预后差。玻璃体视网膜手术在部分病例可挽救眼球并获得有用的视力。

To study clinical features and to determine the relationship between surgical management and visual outcome,we retrospectively analyzed thirteen patients with intraoperative suprachoroidal hemorrhage.Clinical and echographic examination found that all patients had vitreous hemorrhage,most of them had 360° suprachoroidal hemorrhage and hyphema without retinal detachment.Four patients underwent posterior drainage sclerotomy,four patients underwent drainage followed by vitreoretinal surgery. Finally,three patients who had a secondary vitreoretinal surgery achieved a visual outcome of 005～012,one patient had a visual outcome of hand motion and all others resulted in total blindness. The prognosis after massive suprachoroidal hemorrhage has been poor,while vitreoretinal surgery may salvage useful vision in some patients. It is most important to identify the risk factors that may predispose to suprachoroidal hemorrhage and put prevention first.