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Risk Factors for Severe Bleeding Complications in Vitreoretinal Surgery and the Role of Antiplatelet or Anticoagulant Agents.
- Source :
-
Ophthalmology. Retina [Ophthalmol Retina] 2021 Aug; Vol. 5 (8), pp. e23-e29. Date of Electronic Publication: 2021 Apr 26. - Publication Year :
- 2021
-
Abstract
- Purpose: To evaluate the influences and risk factors for severe bleeding complications during vitreoretinal surgery and to investigate the role of antiplatelet and anticoagulant agents.<br />Design: Prospective trial.<br />Participants: Patients undergoing vitreoretinal surgery.<br />Methods: The procedures included were pars plana vitrectomy and scleral buckling. We developed a uniform classification to grade the bleeding severity. Bleeding was graded on an ordinal scale ranging from 0 to 5. Immediately after surgery and 1 day later, the incidence and the severity of bleeding events was documented on a standardized form. A grade of 3 or more was defined as severe bleeding. Furthermore, the influence of known systemic disorders before surgery, the type of anesthesia, type of surgical procedure, intraoperative blood pressure, and the use or change of antiplatelet or anticoagulant agents on intraoperative bleeding was analyzed.<br />Main Outcome Measures: Incidence and risk factors for severe intraoperative bleeding events.<br />Results: Data from 374 eyes undergoing vitreoretinal procedures were included in our study (mean age, 67.6 ± 12.9 years). A severe intraoperative bleeding event was observed in 15 eyes (4%). We found that concomitant diseases such as diabetes mellitus and carotid artery stenosis, the presence of diabetic retinopathy, younger age, and scleral buckling combined with a transscleral puncture were associated significantly with severe bleeding events. By contrast, use of antiplatelet or anticoagulant agents, or both, had no significant influence on severe intraoperative bleeding events.<br />Conclusions: Although external manipulations during buckling surgery (e.g., drainage of subretinal fluid) and concomitant diseases such as diabetes mellitus and carotid artery stenosis influences the risk of severe intraoperative bleeding events, we did not detect an increased risk related to coexisting antiplatelet or anticoagulant medication use, or both.<br /> (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Cardiovascular Diseases complications
Eye Hemorrhage chemically induced
Eye Hemorrhage diagnosis
Follow-Up Studies
Germany epidemiology
Humans
Incidence
Middle Aged
Prognosis
Prospective Studies
Retinal Diseases complications
Risk Assessment
Risk Factors
Severity of Illness Index
Young Adult
Anticoagulants adverse effects
Blood Loss, Surgical statistics & numerical data
Cardiovascular Diseases drug therapy
Eye Hemorrhage epidemiology
Platelet Aggregation Inhibitors adverse effects
Retinal Diseases surgery
Vitreoretinal Surgery adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2468-6530
- Volume :
- 5
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Ophthalmology. Retina
- Publication Type :
- Academic Journal
- Accession number :
- 33915331
- Full Text :
- https://doi.org/10.1016/j.oret.2021.04.013