Antiplatelet and anticoagulation therapy in vitreoretinal surgery
- Authors
- Oh J.; Smiddy W.E.; Kim S.S.
- Issue Date
- 2011
- Publisher
- Elsevier Inc.
- Citation
- American Journal of Ophthalmology, v.151, no.6, pp 934 - 939.e3
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- American Journal of Ophthalmology
- Volume
- 151
- Number
- 6
- Start Page
- 934
- End Page
- 939.e3
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/14145
- DOI
- 10.1016/j.ajo.2010.09.035
- ISSN
- 0002-9394
1879-1891
- 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, χ2 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. © 2011 Elsevier Inc. All rights reserved.
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Collections - 2. Clinical Science > Department of Ophthalmology > 1. Journal Articles
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