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Managing Delayed Suprachoroidal Hemorrhage After Insertion of XEN45 Glaucoma Device

Stringa, Francesco MD; Ali, Zaria MD; Christou, Savvas MD; Karandikar, Sumita MD; Shankar, Vikas MD

doi: 10.1097/IJG.0000000000001170
Online Articles: Case Report/Small Case Series

A 78-year-old man with angle closure glaucoma and on treatment with oral anticoagulants, underwent phacoemulsification. An early acute suprachoroidal hemorrhage (SCH) occurred and the surgical wound was rapidly sutured without complete soft lens matter removal, nor insertion of intraocular lens. The SCH was managed conservatively and it resolved in 5 weeks; the intraocular pressure was 35 mm Hg despite maximal medical treatment. Secondary soft lens matter removal followed by intraocular lens implantation combined with XEN45 was then performed. After 7 days the patient developed a potentially “kissing” choroidal touch due to significant delayed SCH. This was treated with surgical drainage. Significant suprachoroidal bleeding can occur after minimally invasive glaucoma procedures. Patients on anticoagulant therapy may require careful monitoring while planning glaucoma surgery.

Royal Blackburn and Burnley General Teaching Hospitals, East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom

Disclosure: The authors declare no conflict of interest.

Reprints: Francesco Stringa, MD, Queen’s Medical Center, Derby Road, Nottingham, NG7 2UH United Kingdom (e-mail:

Received October 31, 2018

Accepted November 30, 2018

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