Delayed Suprachoroidal Hemorrhage After Pars Plana Vitrectomy: Five-Year Results of a Retrospective Multicenter Cohort Study

PURPOSE: To determine the incidence, risk factors, andoutcomes of delayed suprachoroidal hemorrhage after vitrectomy. DESIGN: Retrospective multicenter cohort study. METHODS: All consecutive patients who underwentprimary vitrectomy, from January 2009 to December2014, at 4 tertiary vitreoretinal centers in Italy wereenrolled. Patient demographics and systemic, ophthalmic,operative, and postoperative data from all centers wereextracted from the electronic record system using standardizeddata collection forms. All eyes that developeddelayed suprachoroidal hemorrhage within 48 hours ofthe end of the vitrectomy were identified as the delayedsuprachoroidal hemorrhage group; all other eyes that underwentvitrectomy in the same period, without delayedsuprachoroidal hemorrhage, were considered the controlgroup. RESULTS: From a total of 4852 vitrectomy procedures,39 cases of delayed suprachoroidal hemorrhage (0.8%)were identified. Multivariable logistic regression showedthat significant risk factors for developing delayed suprachoroidalhemorrhage included advancing age (odds ratio[OR], 2.22; P < .001), longer axial length (OR, 2.57;P < .001), presence of rhegmatogenous retinal detachment(OR, 3.27; P [ .005), extensive intraoperativephotocoagulation (OR, 4.94; P < .001), and emesispostoperatively (OR, 24.39; P < .001). Decision-treeanalysis showed that the stronger predictors of delayedsuprachoroidal hemorrhage were emesis postoperatively(P < .001) and extensive intraoperative photocoagulation(P < .001). After a mean follow-up of 27 ±8 months, the best-corrected visual acuity decreasedfrom 1.3 preoperatively to 1.6 logarithm of minimal angleof resolution at last follow-up (P<.001). CONCLUSIONS: Delayed suprachoroidal hemorrhage occursin 0.8% of vitrectomized eyes.