Expulsive haemorrhage, more accurately termed suprachoroidal haemorrhage, is a rare but serious complication where bleeding occurs in the potential space between the choroid and sclera ¹. It is associated with sudden drops in intraocular pressure during surgery. While it can occur without PCR, the risk environment overlaps: capsule rupture can be associated with instability of the eye’s internal pressure and prolonged surgery.
Why it matters:
- It can cause rapid shallowing of the anterior chamber
- It can threaten retinal function and final visual outcome
- It requires immediate surgical control of the eye (closing wounds, stabilising pressure)
Risk factors include advanced age, hypertension, anticoagulation status, high myopia, and complex surgery ² . Importantly, modern phacoemulsification through small incisions has reduced its incidence compared with older techniques ¹.
When surgeons discuss it, it is not to alarm you, it is because it is one of the complications that explains why, after PCR, the emphasis shifts toward stabilising the eye rather than pursuing refractive ambition.
Preventive strategies include optimising systemic blood pressure, avoiding excessive intraoperative decompression, and selecting anaesthesia and surgical conditions appropriate for higher-risk patients ².
Even when suprachoroidal haemorrhage occurs, prompt recognition and modern vitreoretinal management can preserve useful vision in many cases ³.
References
- Chu TG, Green RL. Suprachoroidal hemorrhage. Surv Ophthalmol. 1999;43(6):471-486.
- Speaker MG, Guerriero PN, Met JA, Coad CT, Berger A, Marmor M. A case-control study of risk factors for intraoperative suprachoroidal expulsive hemorrhage. Ophthalmology. 1991;98(2):202-210.
- Lakhanpal V, Schocket SS, Elman MJ, et al. Intraoperative suprachoroidal hemorrhage: management and outcome. Ophthalmology. 1989;96(7):1082-1087.
Related Topics
- What is Posterior Capsule Rupture?
- Why is my risk of retinal detachment increased after PCR?
- Why is there increased cystoid macular oedema (CMO) after PCR?
- Why might my eye pressure rise after PCR?
- When will I be seen again after PCR?
- What does PCR mean for my bilateral surgery?
- Will my vision be ok after posterior capsule rupture?
- Will my vision be ok after dropped nucleus surgery following PCR?
- How long will the operation take if PCR occurs?
- Can I go to Moorfields for a second opinion instead?
- If I seek a second opinion, can I still have my corrective surgery at Blue Fin Vision®?
- What happens to my fees if I cancel the second eye after PCR?
- Is my risk higher for the second eye if I had PCR in the first?
- What is anterior vitrectomy and why is it performed after PCR?
- What is a three-piece monofocal lens and why is it used after PCR?
- What is a sulcus supplementary (Sulcoflex) lens?
- What is dropped nucleus and why does it happen after PCR?
- What is expulsive suprachoroidal haemorrhage and why is it mentioned with PCR?
- Why does pseudoexfoliation increase the risk of PCR?
- Why do very dense cataracts increase the risk of PCR?
- Is posterior capsule rupture negligence?
