Häufigkeit der intra- und frühen postoperativen Blutungskomplikationen bei Netzhautoperationen in Abhängigkeit von gerinnungshemmenden Substanzen

Frequency of intra- and early postoperative bleeding complications during retinal surgery depending on hemostasis-modulating agents

by Annika Hildegard Joßberger
Doctoral thesis
Date of Examination:2024-05-08
Date of issue:2024-04-26
Advisor:Prof. Dr. Nicolas Feltgen
Referee:Prof. Dr. Nicolas Feltgen
Referee:Prof. Dr. Dorothee Mielke
Referee:Prof. Dr. Margarete Schön
Persistent Address: http://dx.doi.org/10.53846/goediss-10462

 

 

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Abstract

English

In numerous fields of operative medicine, high-quality studies and guidelines are available for the perioperative management of hemostasis-modulating agents. However, in vitreoretinal surgery, meaningful recommendations are currently lacking. Ophthalmic surgeons face the preoperative challenge of balancing intra- and postoperative bleeding risk against individual thromboembolic risk. In this study, the records of 2,581 patients who received vitrectomy or vitrectomy combined with scleral buckling at University medical Center in Goettingen between January 2012 and October 2017 were retrospectively analyzed. The main focus was on the prevalence of severe bleeding complications requiring either re-operative surgery or causing permanent visual loss. Such severe hemorrhagic events were relatively rare, occurring at a rate of 0.9 percent (n=23). Alterations in anticoagulant medication did not yield a substantial difference in the frequency of severe bleeding complications. Similarly, the type of surgery, anesthesia, or coagulation were not significant risk factors for severe hemorrhagic events. Based on the results of this study, the recommendation of other studies to continue anticoagulant medication in patients with mild to moderate bleeding risk during retinal surgery can be supported.
Keywords: retinal surgery; anticoagulation; retinal bleeding; vitrectomy; hemorrhage
Schlagwörter: Vitreoretinale Chirurgie; Antikoagulation; Retinale Blutung; Vitrektomie
 
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