RISK OF ACUTE SUPRACHOROIDAL HEMORRHAGE WITH PHACOEMULSIFICATION

Purpose: To establish whether small incision cataract surgery with pha coemulsification decreases the risk of acute suprachoroidal hemorrhage (ASCH) compared with traditional nucleus expression by extracapsular c ataract extraction (ECCE). Setting: St. Erik Eye Hospital, Stockholm, Sweden. Methods: A retrospective study was done on the incidence of AS CH in cataract surgery between July 1990 and July 1996. During this pe riod, 37,565 cataract extractions (phacoemulsification and ECCE were p erformed at St. Erik Eye Hospital, combined procedures excluded. The c riteria for diagnosis were the suspicion of ASCH during surgery and a verified diagnosis via an expulsive hemorrhage into the wound (4 cases ), postoperative ultrasonic examination (20 cases), or a choroidal mas s on performing ophthalmoscopy together with a postoperative history a lluding to the diagnosis (2 cases). Results: Twenty-six eyes were iden tified with ASCH, including 7 during phacoemulsification and 19 during ECCE. The incidence of ASCH was 0.03% in the 23,213 phacoemulsificati on cases and 0.13% in the 14,352 ECCE cases. The difference was statis tically significant (P =.0003; chi-square test). Conclusion: Small inc ision surgery with phacoemulsification decreased the risk of ASCH in c ataract surgery compared with the traditional nucleus expression techn ique.