The use of intravitreal thrombin to control hemorrhage during vitrectomy

The ability of intravitreal bovine thrombin to control intraoperative bleeding was investigated by a prospective double blind study of 28 consecutive patients with vascularized preretinal membranes undergoing vitrectomy for diabetic retinopathy. Addition of thrombin (100 units/ml) to the vitrectomy infusate was associated with a significantly reduced intraocular bleeding time after cutting vascularized membranes. The mean bleeding time without thrombin was 111.5 seconds, compared to 12.3 seconds with intravitreal thrombin (P less than 0.0001). Patients receiving thrombin had less overall bleeding during surgery and less vitreous hemorrhage on the second postoperative day. Intravitreal bovine thrombin was associated with increased postoperative intraocular inflammation in 20% of patients receiving thrombin. This inflammation could be controlled by use of frequent topical steroids.