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.
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