Anatomical and visual results of transconjunctival sutureles vitrectomy using subconjunctival anesthesia performed on select patients taking anticoagulant and antiplatelet agents

Amina I. Malik, Robert E. Foster, Zelia M. Correa, Michael R. Petersen, Daniel M. Miller, Christopher D. Riemann

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: The purpose of this study was to report the observed outcomes of anticoagulated patients undergoing transconjunctival sutureless vitrectomies using subconjunctival anesthesia without preoperative cessation of anticoagulation and antiplatelet (AC/AP) agents. METHODS: A retrospective chart review was performed on patients taking AC/AP agents who were undergoing transconjunctival sutureless vitrectomies with subconjunctival anesthesia between January 2007 and June 2009. Intra-and postoperative complications (such as massive hemorrhage), anatomical results, satisfactory analgesia (informed by patients and recorded by surgeon), anatomical results, and visual acuity were documented. RESULTS: Sixty-three surgeries were performed on 56 eyes of 52 patients. Thirty-two patients were taking aspirin and clopidogrel, 18 were taking warfarin, 5 were taking clopidogrel, 3 were taking aspirin and warfarin, 2 were taking acetylsalicylic acid and dipyridamole, and 1 was taking warfarin and clopidogrel. All patients had satisfactory analgesia. No intraoperative complications occurred. Seven eyes (13%) had postoperative vitreous hemorrhage. Overall, 79% of patients had improved postoperative visual acuity, 16% of patients had unchanged visual acuity, and 5% of patients had worse visual acuity at last follow-up visit. CONCLUSION: Medical disease requiring systemic AC/AP therapy is often present in patients with vitreoretinal disease. Transconjunctival sutureless vitrectomies using subconjunctival anesthesia may be a safe and effective surgical option in select patients in whom cessation of AC/AP and/or delayed ophthalmic intervention is imprudent.

Original languageEnglish (US)
Pages (from-to)905-911
Number of pages7
JournalRetina
Volume32
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

Keywords

  • anticoagulation
  • antiplatelet
  • hemorrhage
  • subconjunctival anesthesia
  • sutureless transconjunctival vitrectomy
  • vitrectomy

ASJC Scopus subject areas

  • Ophthalmology

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