Perioperative Choroidal Hemorrhage at Pars Plana Vitrectomy: A Case-control Study

Abstract

Risk factors for choroidal hemorrhage during pars plana vitrectomy surgery are currently not well defined. The authors analyzed potential risk factors for perioperative choroidal hemorrhage at pars plana vitrectomy in a case-control study. Of 683 consecutive vitrectomy procedures, 13 cases of choroidal hemorrhage were identified in the operative or immediate postoperative period. Fifty vitrectomy controls from the same period were randomly selected and were compared with the hemorrhage cases by univariate analysis with respect to various potential risk factors. The incidence of choroidal hemorrhage associated with vitrectomy was 1.9%. Statistically significant risks (P < or = 0.05) included: greater age (mean, 70.9 versus 52.1 years); elevated preoperative pressure (19.9 versus 13.0 mmHg); preoperative diagnosis of rhegmatogenous retinal detachment (relative risk, 8.1); aphakic or pseudophakic status (relative risk, 5.2); and scleral buckle procedure at vitrectomy (relative risk, 12.0). Eyes with previous ocular trauma and previous vitrectomy had a reduced risk of choroidal hemorrhage. The incidence of severe visual loss (final visual acuity < 5/200) did not differ significantly from controls. Significant risk factors for choroidal hemorrhage are identified in this study which may help to identify patients at increased risk for this complication. Good visual outcome is possible after choroidal hemorrhage at vitrectomy (69% with visual acuity > 5/200).