title: A case-control study to assess aspirin as a risk factor of bleeding in rhegmatogenous retinal detachment surgery.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the hemorrhagic risk factors during the management of primary rhegmatogenous retinal detachment (RD).
  
  
  METHODS
  Three hundred and twenty-two patients with (n = 74) or without (n = 248) bleeding (anterior segment, choroidal, intravitreal and/or subretinal) during or after RD surgery were included in this case-control study. Exclusion criteria were: history of trauma, vitreoretinal surgery, diabetic retinopathy, and taking clopidogrel and/or a vitamin K antagonist. Univariate and multivariate analyses were performed to identify risk factors of perioperative bleeding.
  
  
  RESULTS
  Aspirin was not significantly associated with bleeding complications during or after surgery (p = 0.8). Scleral buckling (with cryotherapy and gas tamponnade) was performed in 47 % of the cases and pars plana vitrectomy in 53 % of the cases. Independent risk factors of perioperative hemorrhage were the number of cryotherapy impacts (odds ratio =1.12 [1.06; 1.20], 95 % confidence interval), transscleral drainage (OR = 4.22 [1.62; 10.98]), and use of pars plana vitrectomy (OR = 3.39 [1.36; 8.47]). Bleeding complications were associated with a lower single-operation anatomical success rate (74 % vs 84 %, p = 0.03). There was also a trend toward an association between bleeding complications, a higher total number of RD recurrences (0.19 ± 0.5 in the non-bleeding group vs 0.34 ± 0.6, p = 0.06), and a lower final visual acuity (0.5 ± 0.6 logMAR vs 0.7 ± 0.7, p = 0.09).
  
  
  CONCLUSIONS
  This case-control study suggests that aspirin is not a major risk factor of hemorrhagic complications during and after RD surgery. Perioperative bleeding leads to a lower single-operation anatomic success rate.
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France.|Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Brillat
authors.affiliation: Kleber Center of Ophthalmology, Lyon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Rouberol
authors.affiliation: Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Palombi
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France.|INSERM CIC03, Clinical Research Center, University Hospital, CHU Grenoble, Grenoble, F-38043, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Quesada
authors.affiliation: Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Bernheim
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France.|Department of Anaesthesia, University Hospital, CHU Grenoble, Grenoble, F-38043, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Albaladejo
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France.|Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Aptel
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France.|Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Romanet
authors.affiliation: UJF-Grenoble 1, Grenoble, F-38041, France. christophe.chiquet@inserm.fr.|Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble Cedex 09, F-38043, France. christophe.chiquet@inserm.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Chiquet
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D016022:Case-Control Studies; D002832:Choroid Hemorrhage / Q000209:etiology*; D017679:Cryotherapy; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery*; D012166:Retinal Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D012591:Scleral Buckling; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000209:etiology*
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Aspirin; Bleeding; Complication; Hemorrhage; Retinal detachment