title: Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents.
abstract: BACKGROUND
  To evaluate the effect of perioperative anticoagulation and antiplatelet therapy on postoperative vitreous cavity haemorrhage following pars plana vitrectomy for diabetic eye disease.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  139 patients.
  
  
  METHODS
  Retrospective collection of demographic, medical, surgical and postoperative data of all patients undergoing vitrectomy for diabetic eye disease at The Royal Victorian Eye and Ear Hospital.
  
  
  METHODS
  Correlation of the rates of persistent vitreous cavity haemorrhage and anticoagulation or antiplatelet treatment.
  
  
  RESULTS
  Sixty-eight of 155 (43.9%) eyes of 139 patients were on anticoagulation or antiplatelet therapy prior to surgery. At the time of surgery, 29 (42.6%) were on therapy. Eight of 29 (27.6%) patients had significant persistent vitreous cavity haemorrhage in the postoperative period, with four (13.8%) requiring secondary surgery. Thirty-nine (57.4%) patients had discontinued therapy prior to surgery. Among these, four (10.3%) had persistent bleeding, of which three (7.7%) required additional surgery. Six of 87 (6.9%) patients not on any anticoagulation/antiplatelet therapy had persistent postoperative vitreous cavity haemorrhage, with none requiring further surgery. Patients on anticoagulation/antiplatelet therapy at the time of surgery were more likely to experience persistent haemorrhage and subsequent reoperation (OR = 4.8, P = 0.0045 and OR = 6.6, P = 0.024, respectively).
  
  
  CONCLUSIONS
  Perioperative continuation of anticoagulation or antiplatelet treatment appears to increase the risk of persistent postoperative vitreous cavity haemorrhage and the necessity for vitreous cavity washout in this diabetic cohort. Appropriate preoperative cessation of treatment appeared to reduce this risk; however, caution must be taken with regard to the systemic risk associated with cessation of therapy.
authors.affiliation: Vitreoretinal Unit, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. dfabinyi@gmail.com
authors.forename: David C A
authors.initials: DC
authors.lastname: Fabinyi
authors.forename: Evelyn C
authors.initials: EC
authors.lastname: O'Neill
authors.forename: Paul P
authors.initials: PP
authors.lastname: Connell
authors.forename: J Ben
authors.initials: JB
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000139:chemically induced* / Q000601:surgery; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors