[Vis-à-tergo. Uveal effusion and expulsive hemorrhage in cataract surgery].

BACKGROUND

Since introduction of the self-sealing incision for cataract surgery it has been possible to avoid serious complications due to an acute rise in intraocular pressure. Chorioidal effusion (CE) and expulsive hemorrhage (EH) should be determined and treated differently.

PATIENTS AND

METHODS

The incidence of vis-à-tergo in our patients was 1.7%. CE was ascertained in 0.1%; in one case, the operation had to be interrupted. EH occurred in one patient (0.03%) in the last 3,000 cataract operations. Differential diagnoses were made by ultrasonic examination.

RESULTS

Operations in CE cases were completed without further complications. However, in one case the operation was interrupted and the procedure was completed on the following day. A 63-year-old woman with EH had a massive rise in intraocular pressure directly after lens implantation with a peripheral capsular rupture. Postoperatively, a chorioidal hemorrhage in two quadrants, including the macula, was found. One week after surgery a posterior sclerotomy was performed with simultaneous infusion into the anterior chamber with BSS. The nearly complete chorioidal reattachment was achieved after drainage of the liquified blood. Visual acuity has improved to 0.5.

CONCLUSION

Vis-à-tergo in modern cataract surgery only rarely results in an ES or EH. Also, in an EH there is an incomplete form. After an adequate therapeutic procedure good visual function can be expected.