title: Maintenance of anticoagulant and antiplatelet agents for patients undergoing peribulbar anesthesia and vitreoretinal surgery.
abstract: OBJECTIVE
  To establish the prevalence of anticoagulation (vitamin K antagonists) and antiplatelet agent therapy in patients undergoing vitreoretinal surgery and to compare the outcome of peribulbar anesthesia and vitreoretinal surgery between users and nonusers.
  
  
  METHODS
  We conducted a retrospective case series study in one academic center. No changes in the treatment regimen were made before surgery. Patients were divided into 3 groups: G1, patients with no anticoagulant or antiplatelet therapy; G2, patients treated with anticoagulants; and G3, patients treated with aspirin, clopidogrel, or both.
  
  
  RESULTS
  Two hundred and six eyes (206 patients) were included. G1, 144 eyes (69.9%) without any anticoagulant or antiplatelet therapy (69.9%); G2, 12 eyes (5.8%) with anticoagulants; and G3, 44 eyes (21.4%) with antiplatelet agents. Six patients (6 eyes) (2.9%) received both anticoagulant and antiplatelet agents. The incidence of overall and mild postoperative hemorrhagic complications was similar between groups, P = 0.075 and P = 0.127, respectively. However, potential sight-threatening hemorrhagic complications were more frequent in patients receiving antiplatelet agents, P < 0.003.
  
  
  CONCLUSIONS
  Peribulbar anesthesia for vitreoretinal surgery can probably be performed safely in patients receiving anticoagulants. However, retinal surgeons should be aware that severe bleeding complications are more frequent in patients receiving antiplatelet therapy.
authors.affiliation: Department of Ophthalmology, University Hospital, Dijon, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Passemard
authors.forename: Philippe
authors.initials: P
authors.lastname: Koehrer
authors.forename: André
authors.initials: A
authors.lastname: Juniot
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bron
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000074:Acenocoumarol / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D000077144:Clopidogrel; D016292:Procedural Sedation; D004562:Electrocardiography; D005130:Eye Hemorrhage / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit; D010092:Oximetry; D010630:Phenindione / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000139:chemically induced; D012189:Retrospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D057586:Vitreoretinal Surgery; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D010630:Phenindione; D014859:Warfarin; D000077144:Clopidogrel; C017673:fluindione; D000074:Acenocoumarol; D013988:Ticlopidine; D001241:Aspirin