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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Delayed suprachoroidal hemorrhage after Descemet Stripping Automated Endothelial...
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Vol. 98. Issue 6.
Pages 355-359 (June 2023)
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Vol. 98. Issue 6.
Pages 355-359 (June 2023)
Short communication
Delayed suprachoroidal hemorrhage after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)
Hemorragia supracoroidea diferida después de queratoplastia endotelial automatizada con pelado de la membrana de Descemet (DSAEK)
D. Oliver-Gutierreza,
Corresponding author
david.oliver@vallhebron.cat

Corresponding author.
, S. Martin Naldaa, G. Segura-Duchb, P. Bucka, E. Ros-Sancheza, L. Bisbea
a Hospital Universitario Vall d’Hebron University, Barcelona, Spain
b Centro Oftalmológico Barraquer, Barcelona, Spain
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Abstract

This study, a case series of 2 patients and a literature review, aims to describe the second and third known cases of delayed suprachoroidal hemorrhage after Descemet stripping automated endothelial keratoplasty. The suprachoroidal hemorrhage is defined as the presence of blood in the suprachoroidal space; final visual acuity is rarely greater than 0.1 (decimal scale). Both cases presented had known risk factors: high myopia, previous ocular surgeries, arterial hypertension, and being under anticoagulant therapy. The diagnosis of delayed suprachoroidal hemorrhage was made at the 24-h follow-up visit, as they recalled a sudden and tremendous acute pain hours after surgery. Both cases were drained through a scleral approach.

Delayed suprachoroidal hemorrhage is a rare but devastating consequence that can occur after Descemet stripping automated endothelial keratoplasty. Awareness of the most critical risk factors allows for early identification, which is of paramount importance for the prognosis of these patients.

Keywords:
Suprachoroidal hemorrhage
Delayed suprachoroidal hemorrhage
Descemet stripping automated endothelial keratoplasty
Corneal lamellar transplantation
Surgery complications
Resumen

Este estudio, una serie de 2 casos y revisión de la literatura, pretende describir el segundo y tercer caso conocido de hemorragia supracoroidea diferida (DSCH) tras una queratoplastia endotelial automatizada con pelado de Descemet (DSAEK). La hemorragia supracoroidea es la presencia de sangre en el espacio supracoroideo. La agudeza visual final no suele superar el 0,1 (escala decimal). Ambos casos presentan factores de riesgo: alta miopía, cirugía intraocular previa, hipertensión arterial o estar anticoagulados. El diagnóstico de hemorragia supracoroidea diferida se realizó en la primera visita de seguimiento: referían un dolor intenso y agudo horas después de la cirugía. Fueron tratados con drenaje transescleral.

La hemorragia supracoroidea diferida es una complicación rara pero devastadora y puede ocurrir después de un trasplante lamelar, como la queratoplastia endotelial automatizada con pelado de Descemet. Conocer esta complicación así como sus factores de riesgo permitirá un diagnóstico temprano, lo que mejorará el pronóstico de los pacientes.

Palabras clave:
Hemorragia supracoroidea
Hemorragia supracoroidea diferida
Queratoplastia endotelial automatizada con pelado de la membrana de Descemet
Trasplante corneal lamelar
Complicaciones quirúrgicas

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