内眼手术并发脉络膜上腔出血的临床分析

目的：探讨内眼手术术中和术后并发脉络膜上腔出血(suprachoroidal hemorrhage， SCH)的临床特点以及发生的危险因素，观察其视力预后。

方法：回顾性分析2005-06/2015-06共10a间本科收治的手术相关的SCH患者13例13眼，年龄22～76岁。13例13眼患者中，合并高度近视者6眼(46%)，有高眼压病史者6眼(46%)，合并高血压病者4眼(31%)。术中发生的驱逐性出血8眼，术后发生者迟发性出血5眼； 7眼为硅油取出术并发，4眼为白内障囊外取出术并发，1眼为小梁切除联合白内障囊外摘除术并发，1眼为晶状体脱位行晶状体切除联合玻璃体切除手术并发。5眼药物治疗，4眼行巩膜外放液引流联合玻璃体注气术，4眼行玻璃体切割联合重水和硅油注入。

结果：随访10mo，所有SCH全部吸收，最终视力除1眼放弃治疗无光感之外，其余12眼视力光感～0.4。

结论：内眼手术并发的SCH后果严重，高龄、高血压、高度近视和高眼压可能为其危险因素，手术切口导致术中眼压波动大可能与其发生有关，积极治疗后可以维持一定视力。

Clinical analysis of suprachoroidal hemorrhage complicated by intraocular surgery

AIM:To explore clinical characteristics of supracho-roidal hemorrhage(SCH)complicated by intraocular surgery and to observe visual prognosis.

METHODS:A total of 13 eyes(13 cases)with SCH related to intraocular surgery from June 2005 to June 2015 were included and respectively studied. The age of our cases ranged from 22 to 76. Of all, 4 eyes(31%)were concomitant with hypertension, 6 eyes(46%)with high myopia and 6 eyes(46%)with oculi hypertonia, respectively. Intraoperative expulsive SCH occurred in 8 eyes, while postoperative delayed SCH in 5 eyes. The most SCH(7 eyes)happened during the surgery of removing silicone oil, 4 eyes with SCH were related to extracapsular cataract extraction(ECCE), 1 SCH eye was complicated by ECCE combined with trabeculectomy and 1 SCH eye by lensectomy and vitrectomy. As for treatment, 5 eyes took medication alone, 4 eyes were performed drainage sclerotomy and gas tamponade, while the other 4 eyes were accomplished vitrectomy with adjunctive perfluoro-carbon liquids and silicone oil tamponade.

RESULTS:At the 10-month of follow-up, all eyes with SCH were resolved. Except 1 eye with no light perception owing to abandoning treatment, the sights of the other 12 eyes were between light perception and 0.4.

CONCLUSION:SCH complicated by intraocular surgery was rare but with devastating outcome. Aged patients, hypertension, high myopia and oculi hypertonia may be risk factors. In addition, surgical methods in the early years were likely correlated to the occurrence of SCH. Certain sight of the patients with SCH may be maintained after positive treatment.