[Anticoagulation and vitreoretinal surgery].
About one-third of patients undergoing vitreoretinal surgery are receiving anticoagulation therapy. There are no consensus guidelines on anticoagulation in this setting. Sixty patients (mean age 73 y) on anticoagulation therapy underwent vitreoretinal surgery. The indications for anticoagulation included atrial fibrillation, coronary insufficiency, cerebrovascular disease, deep vein thrombosis and prosthetic heart valves. Twenty-two patients (36.7%) were treated with vitamin K antagonists and 38 (67.3%) with antiplatelet agents (clopridogel or aspirin). After sub-tenon anesthesia, the surgical procedure was performed as usual, regardless of preoperative treatment and intercurrent disease. One patient who underwent a major procedure for complicated retinal detachment had an intraoperative subretinal hemorrhage requiring retinectomy. No other complications occurred. These results suggest that no change in ongoing anticoagulation therapy is required for patients scheduled for vitreoretinal surgery.
Chauvaud
Dominique
D
Hôtel-Dieu, Service d'Ophtalmologie, 1 pl. du Parvis Notre-Dame, 75181 Paris Cédex 04.
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D000077144:Clopidogrel; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011300:Preoperative Care; D012160:Retina / Q000601:surgery; D012163:Retinal Detachment / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000601:surgery*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin