Suprachoroidal hemorrhage, often a devastating complication of intra-ocular surgery or trauma, can result in rapid vision loss and globe deformation due to accumulation of blood in the suprachoroidal space. Traditionally, delayed surgical drainage is performed after clot liquefaction, typically about 10 days post-hemorrhage. Tissue plasminogen activator (tPA) has been explored as an adjunctive treatment for suprachoroidal hemorrhage to facilitate clot liquefaction and surgical drainage. Supra-choroidal injection of tPA may accelerate this process by enzymatically breaking down fibrin, enabling earlier and more complete evacuation of the hemorrhage. Using tPA as shown in this video can reduce intraocular pressure, improve surgical outcomes, and help preserve visual function. Our guest surgeon, Professor Ramesh Ayyala at USF Tampa teaches us the proper way to manage these challenging patients.
