Vitrectomy and fluid infusion in the treatment of delayed suprachoroidal hemorrhage after combined cataract and glaucoma filtration surgery.

I report the successful treatment of one case of massive, delayed suprachoroidal hemorrhage that occurred after combined intracapsular cataract extraction and trabeculectomy. Significant vitreous incarceration in the filtration site and consequent vitreoretinal traction were present so that a limbal approach anterior vitrectomy was necessary before choroidal drainage could be accomplished safely. An infusion of balanced salt solution through a limbal infusion cannula was employed during vitrectomy and also during drainage of suprachoroidal blood. The simultaneous intravitreal infusion helped to create an efficient, controlled choroidal drainage procedure. In addition to relieving vitreoretinal traction, this technique helps prevent the periods of extreme hypotony experienced when choroidal drainage and anterior chamber reformation are accomplished serially in step-wise fashion. This use of this method also obviates the compromised view of the peripheral retina which occurs when air is introduced into the vitreous cavity.