Suprachoroidal hemorrhage during femtosecond laser assisted cataract surgery

Purpose: To describe a case of suprachoroidal hemorrhage that occurred during femtosecond laser assisted cataract surgery (FLACS). Observations: A 67-year-old woman with high myopia underwent FLACS. Following two unsuccessful attempts at docking due to interface air bubbles, the third attempt was successful. Laser treatment and cataract surgery proceeded uneventfully until intraocular lens (IOL) implantation. While positioning the IOL within the capsular bag, the anterior chamber began to shallow, intraocular pressure became high by palpation, and the optic of the IOL prolapsed partially out of the bag. A segmental suprachoroidal hemorrhage was identified in the superior peripheral retina by intraoperative indirect ophthalmoscopy. Following an hour of waiting in the recovery room, the anterior chamber deepened and the intraocular pressure was low enough to position the IOL centrally within the bag. Her subsequent postoperative course was uneventful. Conclusions and Importance: To our knowledge, this is the first report of suprachoroidal hemorrhage during FLACS. We speculate that repeated sudden drops in intraocular pressure associated with multiple undockings triggered the suprachoroidal hemorrhage in this case.