Abstract
The number of elderly patients using anticoagulant and antiplatelet treatment in prevention of thromboembolism has significantly increased in recent years. It was believed for many years that those patients may be at higher risk for hemorhages during ocular surgery. Different strategies were proposed to prevent these complications, including discontinuation of anticoagulants, dose reduction, or substitution with low molecular weight heparin. The objective of this work was to evaluate the results of studies presenting the results of vitreoretinal surgeries in patients continuing antiplatelet and/or anticoagulant treatment. We performed a PubMed search of possible intraoperative and postoperative hemorrhages in patients receiving anticoagulant and/or antiplatelet therapy during vitreoretinal surgery in 2007-2014. In most of the studies reviewed there was no substantial increase in intraoperative and postoperative hemorrhages risks during vitreoretinal surgery. However, in some studies, a substantially increased risk has been identified. We conclude that the available data is insufficient to decide whether to continue or discontinue anticoagulant and/or antiplatelet therapy during vitreoretinal surgery and we recommend an individualized approach in consultation with the patient’s medical doctors and anesthesiologists.
Keywords: Vitreo-retinal surgery complications, ocular surgery complications, anticoagulants in ocular surgery.
Current Pharmaceutical Design
Title:Controversies in Anticoagulant Therapy in Vitreo-Retinal Surgery
Volume: 21 Issue: 32
Author(s): Andrzej Grzybowski, Konrad Kupidura-Majewski and Paulina Kupidura
Affiliation:
Keywords: Vitreo-retinal surgery complications, ocular surgery complications, anticoagulants in ocular surgery.
Abstract: The number of elderly patients using anticoagulant and antiplatelet treatment in prevention of thromboembolism has significantly increased in recent years. It was believed for many years that those patients may be at higher risk for hemorhages during ocular surgery. Different strategies were proposed to prevent these complications, including discontinuation of anticoagulants, dose reduction, or substitution with low molecular weight heparin. The objective of this work was to evaluate the results of studies presenting the results of vitreoretinal surgeries in patients continuing antiplatelet and/or anticoagulant treatment. We performed a PubMed search of possible intraoperative and postoperative hemorrhages in patients receiving anticoagulant and/or antiplatelet therapy during vitreoretinal surgery in 2007-2014. In most of the studies reviewed there was no substantial increase in intraoperative and postoperative hemorrhages risks during vitreoretinal surgery. However, in some studies, a substantially increased risk has been identified. We conclude that the available data is insufficient to decide whether to continue or discontinue anticoagulant and/or antiplatelet therapy during vitreoretinal surgery and we recommend an individualized approach in consultation with the patient’s medical doctors and anesthesiologists.
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Cite this article as:
Grzybowski Andrzej, Kupidura-Majewski Konrad and Kupidura Paulina, Controversies in Anticoagulant Therapy in Vitreo-Retinal Surgery, Current Pharmaceutical Design 2015; 21 (32) . https://dx.doi.org/10.2174/1381612821666150909095237
DOI https://dx.doi.org/10.2174/1381612821666150909095237 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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