Purpose: To describe a case of massive suprachoroidal hemorrhage after a phacoemulsification managed with pars plana vitrectomy, heavy silicone oil (Densiron), and supine position. Methods: Report of a 69-year-old woman with systemic hypertension and under antiplatelet treatment who developed a massive suprachoroidal hemorrhage. Results: The patient underwent a pars plana vitrectomy and heavy oil endotamponade combined with 3 radial sclerotomies to drain the suprachoroidal blood. Two months after this surgery, the retina remains attached and visual acuity is 3/60 with aphakia and half of the vitreous cavity filled with Densiron. Conclusion: Pars plana vitrectomy and Densiron endotamponade with supine position can represent a good surgical option in such a dramatic case as a suprachoroidal hemorrhage. Long-term heavy silicone oil endotamponade cannot be advised in these cases.
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