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Antiplatelet and anticoagulation therapy in vitreoretinal surgery.

Authors
 Jaeryung Oh  ;  William E. Smiddy  ;  Sung Soo Kim 
Citation
 AMERICAN JOURNAL OF OPHTHALMOLOGY, Vol.151(6) : 934-3, 2011 
Journal Title
 AMERICAN JOURNAL OF OPHTHALMOLOGY 
ISSN
 0002-9394 
Issue Date
2011
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants/therapeutic use* ; Aspirin/therapeutic use ; Case-Control Studies ; Child ; Contraindications ; Eye Hemorrhage/chemically induced ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/therapeutic use* ; Postoperative Hemorrhage* ; Retrospective Studies ; Risk Factors ; Ticlopidine/analogs & derivatives ; Ticlopidine/therapeutic use ; Vitreoretinal Surgery* ; Warfarin/therapeutic use
Abstract
PURPOSE: To evaluate changes in the prevalence of antiplatelet (aspirin, clopidogrel) and anticoagulation (warfarin) therapy and its possible relationship to postoperative bleeding in vitreoretinal surgery (VRS) patients. DESIGN: Observational, retrospective case control study. METHODS: setting: University practice.study population: A total of 822 patents who underwent VRS during 3 intervals in 1994, 2004, and 2008.observation procedure: Retrospective chart review for 1994 and 2004, but contemporaneous in 2008.main outcome measures: Proportion using antiplatelets or anticoagulants, the incidence of early postoperative intraocular bleeding in patients, and clinical consequence of the hemorrhage. RESULTS: Thirty-one of 213 patients (14.6%) who underwent VRS in 1994, 103 of 361 patients (28.5%) in 2004, and 80 of 248 patients (32.3%) in 2008 had taken antiplatelet therapy (P < .001). The rates of anticoagulant therapy did not vary. The incidence of bleeding was higher (20.0%) in the patients who did not suspend antiplatelets than in those who did (9.6%) (P = .05, χ(2) test), but this difference lost statistical significance in a multivariate analysis (P = .079). Anticoagulant was associated with intraocular hemorrhage at postoperative first day after vitrectomy (P = .03, Fisher exact test). No reoperation or failure of the surgery was attributable to the hemorrhage in anticoagulant or antiplatelet patients. CONCLUSIONS: Use of antiplatelet agents has increased in patients undergoing vitreoretinal surgery but probably does not increase the risk of postoperative intraocular bleeding; however, when safe to suspend even for a short time the potential risk is further reduced. Anticoagulant use was associated with a higher risk, but without serious consequences. Working with a patient's medical doctor may allow safe suspension in some cases, which may further lower these risks.
Full Text
http://www.sciencedirect.com/science/article/pii/S000293941000961X
DOI
10.1016/j.ajo.2010.09.035
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Soo(김성수) ORCID logo https://orcid.org/0000-0002-0574-7993
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95356
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