Continuation of aspirin therapy before pars plana vitrectomy: Safe or not?. Issue 4 (July 2021)

• Record Type: Journal Article
• Authors: Wang, Jin; Li, Qingjian; Zhang, Yu; Che, Xin; Jiang, Jing; Qian, Yiwen; Wang, Zhiliang
• Is Part Of: European journal of ophthalmology. Volume 31:Issue 4(2021)
• Page Start: 2013
• Page End: 2019
• Publication Date: 2021-07
• Subjects: Aspirin -- pars plana vitrectomy -- hemorrhagic complication; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/1120672120946930
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To assess the safety of pars plana vitrectomy (PPV) in patients undergoing systemic treatment with aspirin. Methods: This prospective study enrolled consecutive patients undergoing PPV under percutaneous retrobulbar anesthesia between February 2016 and July 2018. Sixty-seven eyes from 67 patients on regular aspirin therapy were randomized into two groups: the continuation group (33 eyes), with aspirin continued during the perioperative period; and the discontinuation group (34 eyes), with aspirin discontinued for 3 to 7 days before surgery. Forty-three eyes from 43 patients who had no antiplatelet/anticoagulant therapy were used as a control group. Results: There was no significant difference in the incidence of hemorrhagic complications or the need for additional operations due to hemorrhagic complications among the three groups ( p = 0.740 and p = 0.324, respectively). None of the patients in these three groups suffered from thromboembolic events during the follow-up period. Except for one case (3.0%) of lid ecchymosis in the continuation group, no eye experienced bleeding complications associated with the retrobulbar local anesthesia. In the continuation group, three eyes (9.1%) demonstrated postoperative hyphema that resolved spontaneously. In the discontinuation group, two eyes (5.9%) suffered from postoperative vitreous hemorrhage, of which one eye required secondary surgery and the other cleared spontaneously. One eye (2.9%) in the discontinuation group demonstrated postoperative hyphema that absorbed spontaneously. Three eyes (7.0%) in the control group experienced hyphema that absorbed spontaneously. Conclusion: The outcomes of our study indicate that PPV under retrobulbar anesthesia can be safely performed without discontinuing systemic aspirin therapy.