title: Anticoagulation with warfarin in vitreoretinal surgery.
abstract: OBJECTIVE
  To describe the clinical course of patients undergoing vitreoretinal procedures while receiving systemic anticoagulation with warfarin.
  
  
  METHODS
  We reviewed patient demographics, ocular findings, and clinical courses for 25 patients receiving systemic anticoagulation with warfarin who subsequently underwent vitreoretinal surgery.
  
  
  RESULTS
  Patient ages ranged from 49 years to 81 years (median, 69 years). Indications for anticoagulation included atrial fibrillation, cerebrovascular disease, deep vein thrombosis, prosthetic heart valves, and hypercoagulable state. Follow-up ranged from 4 months to 36 months (median, 19.5 months). The international normalized ratio ranged from 1.5 to 3.1 (median, 2.0). Final vision after surgery ranged from 20/20 to 20/400 (median, 20/100). One patient who underwent scleral buckling and external drainage of subretinal fluid had an intraoperative subretinal hemorrhage associated with the drainage procedure. In all other patients, no intraoperative complications occurred.
  
  
  CONCLUSIONS
  Cessation of therapy with warfarin may not be necessary in patients receiving anticoagulation who are undergoing vitreoretinal procedures. Successful visual and anatomical results may be achieved after vitreoretinal surgery for patients receiving anticoagulation with warfarin. The management of anticoagulation should occur in conjunction with the patient's internist to allow a clear understanding of the potential systemic risks of cessation of warfarin treatment preoperatively.
authors: Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California, USA. adfu@westcoastretina.com
authors: Arthur D
authors: AD
authors: Fu
authors: H Richard
authors: HR
authors: McDonald
authors: David F
authors: DF
authors: Williams
authors: Herbert L
authors: HL
authors: Cantrill
authors: Edwin H
authors: EH
authors: Ryan
authors: Robert N
authors: RN
authors: Johnson
authors: Everett
authors: E
authors: Ai
authors: J Michael
authors: JM
authors: Jumper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000188:drug therapy; D017679:Cryotherapy; D005128:Eye Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D019851:Thrombophilia / Q000188:drug therapy; D020246:Venous Thrombosis / Q000188:drug therapy; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery*; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014859:Warfarin