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Perioperative Management of Anticoagulated Patients Undergoing Repeated Intravitreal Injections
Carsten H. Meyer, MD;
Josep Callizo, MD;
Stefan Mennel, MD;
Andrea Kussin, MD
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Dayani and Grand1 performed 57 vitreoretinal surgeries in patients using warfarin sodium and having subtherapeutic (< 1.49 international normalized ratios), borderline (1.50-1.99 international normalized ratios), therapeutic (2.90-2.49 international normalized ratios), or highly therapeutic (> 2.50 international normalized ratios) values. Although postoperative hemorrhages developed in 2 eyes with subtherapeutic values and 2 eyes with therapeutic values, all cleared without treatment. Thus, Dayani and Grand concluded that vitreoretinal surgery is safe while maintaining anticoagulation therapy.
Intravitreal injections using anti–vascular endothelial growth factor drugs are challenging, as they are performed every 4 to 6 weeks for an extended period. Many patients receiving treatment also have coronary or vascular conditions; thus, they are commonly receiving anticoagulant or antiplatelet therapy to reduce their risk of systemic thromboembolic complications.2-3
We recently evaluated the incidence of vitreal hemorrhages after intravitreal injections in our department. Before September . . . [Full Text of this Article]
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Maintenance of Warfarin Anticoagulation for Patients Undergoing Vitreoretinal Surgery
Pouya N. Dayani and M. Gilbert Grand
Arch Ophthalmol. 2006;124(11):1558-1565.
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