PubMed · 9515487
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K S Budinger, D H Abramson, C A Servodidio. Choroidal detachment simulating choroidal melanoma.. https://pubmed.ncbi.nlm.nih.gov/9515487/
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INTRODUCTION: We report a series of 79 eyes undergoing primary surgery for rhegmatogenous retinal detachment associated with severe myopia greater than 10 diopters. Specific surgical procedures are recommended for these patients in order to minimize the high incidence of postoperative hemorrhagic complications. MATERIALS AND METHODS: Seventy-nine eyes of 76 patients treated for retinal detachment with severe myopia greater than 10 diopters were reviewed. Scleral buckling was performed in 21 eyes and pars plana vitrectomy in 58 eyes. RESULTS: After a mean follow-up period of 23.8 months, the final anatomical success rate was 93.7% (74 cases). Postoperative hemorrhagic complications (suprachoroidal hemorrhage and vitreous hemorrhage) occurred in four cases after scleral buckling and in ten cases after vitrectomy. DISCUSSION: In this study, primary scleral buckling for retinal detachment was less frequently performed than vitrectomy. Broad scleral buckling may not be associated with higher postoperative hemorrhagic complications, when the buckle does not extend over six clock hours. Postoperative hemorrhagic complications also occurred after vitrectomy; however, scleral buckling associated with vitrectomy does not seem to increase the complication rate. CONCLUSION: This retrospective study of 79 cases of rhegmatogenous retinal detachment with severe myopia higher than 10 diopters suggests that vitrectomy is often considered a primary procedure. Broad scleral buckling associated with vitrectomy is a safe and effective procedure, with an acceptable incidence of complications when not extending over six clock hours.
PURPOSE: To describe the clinical course of a 52-year-old white man with previously undiagnosed hemophilia who suffered blunt trauma to the right eye with consequent delayed, spontaneous suprachoroidal hemorrhage. DESIGN: Observational case report. METHODS: The patient's clinical course from the time of trauma to postenucleation is discussed and correlated with B-scan ultrasonography and histopathology. RESULTS: The patient developed recurrent hyphemas, delayed choroidal hemorrhage with detachment and eventually loss of the eye. Hematologic evaluation established a diagnosis of mild factor VIII deficiency. CONCLUSION: Despite mild hemophilia, this patient had not experienced any clinically important morbidity until his eye injury. Ophthalmologists should be aware that bleeding disorders such as hemophilia predispose patients to spontaneous intraocular hemorrhage.