{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:15:38Z","timestamp":1777580138039,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,6,11]],"date-time":"2015-06-11T00:00:00Z","timestamp":1433980800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the intraoperative management of choroidal effusion (CE) or suprachoroidal hemorrhage (SCH) during cataract surgery with the phacoemulsification technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study is a retrospective interventional study through which we describe the intraoperative management adopted in 6 cases of CE or SCH during cataract surgery. The study involved 6,400 eyes (phacoemulsification) in 6 years observational time (incidence rate 0.094%). The surgical time at which these complications happened differed: nucleolus phacoemulsification in 2 eyes, cortex removal by bimanual irrigation-aspiration in 3 eyes, and intraocular lens implant for 1 eye. Once the complication was recognized, each patient was quickly moved to an extreme reverse Trendelenburg position and pharmacologically treated to manage high blood pressure, pain, and anxiety (150 mL of an 18% mannitol solution delivered in rapid infusion intravenously; 1-3 mg intravenous midazolam; 5 nifedipine sublingual drops).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all the cases reported, the surgery was completed after resolution of the acute choroidal exudation or SCH. In the follow-up evaluation, the intraocular pressure was normal at each examination. The visual acuity of the patients was between 6\/7.5 and 5\/6 Snellen after 4 weeks. We observed a statistically significant reduction in endothelial cells in the 2 eyes in which the CE or SCH happened during the phacoemulsification compared with the other cases; this finding likely results from mechanical damage (p = 0.04 [95% confidence interval]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Choroidal effusion or SCH can be intraoperatively managed to avoid expulsive hemorrhage and maintain the possibility of completing the surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5301\/ejo.5000707","type":"journal-article","created":{"date-parts":[[2015,11,30]],"date-time":"2015-11-30T06:21:48Z","timestamp":1448864508000},"page":"338-341","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Choroidal Effusion and Suprachoroidal Hemorrhage during Phacoemulsification: Intraoperative Management to Prevent Expulsive Hemorrhage"],"prefix":"10.1177","volume":"26","author":[{"given":"Alfonso","family":"Savastano","sequence":"first","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Careggi, Florence - Italy"},{"name":"Studio Medico Associato Savastano, Cassino (Frosinone) - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanislao","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria Careggi, Florence - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina","family":"Savastano","sequence":"additional","affiliation":[{"name":"Studio Medico Associato Savastano, Cassino (Frosinone) - Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Policlinico Gemelli, Rome - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"S. Maria della Piet\u00e0 Hospital, Casoria (Naples) - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Forte","sequence":"additional","affiliation":[{"name":"Spallanzani Hospital, Frosinone - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Sbordone","sequence":"additional","affiliation":[{"name":"Seconda Universit\u00e0 degli Studi di Napoli (SUN), Naples - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Diurno","sequence":"additional","affiliation":[{"name":"Moscati Hospital, Anesthesia Department, Aversa (Caserta) - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio","family":"Savastano","sequence":"additional","affiliation":[{"name":"Studio Medico Associato Savastano, Cassino (Frosinone) - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,6,11]]},"reference":[{"key":"bibr1-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5942"},{"key":"bibr2-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(98)80202-2"},{"key":"bibr3-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1984.01040031417013"},{"key":"bibr4-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1987.01060030058025"},{"key":"bibr5-ejo.5000707","first-page":"181","volume":"83","author":"Payne JW","year":"1985","journal-title":"Trans Am Ophthalmol Soc"},{"key":"bibr6-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.83.12.1336"},{"key":"bibr7-ejo.5000707","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.02.024"},{"issue":"9","key":"bibr8-ejo.5000707","first-page":"1266","volume":"92","author":"Cantor LB","year":"1985","journal-title":"Suprachoroidal expulsive hemorrhage in glaucoma patients undergoing intraocular surgery. 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