Anticoagulation and clinically significant postoperative vitreous hemorrhage in diabetic vitrectomy

The purpose of this study was to provide further information about the risks of perioperative hemorrhage in diabetic vitrectomy in patients on anticoagulation. This may help us to better understand more about the fine balance between the risks of stopping anticoagulation versus continuation for intraocular surgery.

A retrospective, comparative cohort study of all patients undergoing a diabetic pars plana vitrectomy by a single surgeon over a 30-month period at a single institution was conducted.

Ninety-seven eyes were included for analysis. Twenty-seven eyes remained on anticoagulation during the surgery. There were no perioperative complications related to the anticoagulation. Surgical intervention resulted in a significant increase in visual acuity in both groups. There was no difference in the incidence of postoperative vitreous hemorrhage or surgical reoperation between the two groups. Patients on anticoagulation had significantly worse postoperative vision compared with those not on anticoagulation (best-corrected visual acuity of 20/230 vs. 20/100, P = 0.03).

Patients undergoing diabetic vitrectomy, who are on anticoagulation or antiplatelet agents, do not exhibit a higher risk of intraoperative or postoperative vitreous hemorrhage. Anticoagulants and antiplatelets may be safely continued perioperatively to avoid complications secondary to their systemic disease.