Warfarin in vitreoretinal surgery: a case controlled series

Maintenance of perioperative antiplatelet and anticoagulant therapy for vitreoretinal surgery

“…In a larger subsequent study of 60 patients maintained on anticoagulation for vitrectomy, Chandra et al . found no increase in complications compared with controls and concluded that the risks of stopping anticoagulation outweighs any risks intraoperatively or postoperatively . Fu et al .…”

“…For patients with mechanical heart valve prostheses, the risk of major systemic embolism is increased 3.7 fold without anticoagulation . Despite this, 81% of respondents to an online survey of perioperative management of anticoagulation among members of the British and Eire Association of Vitreoretinal Surgeons suggested that they would withhold warfarin prior to VR surgery and 29% would not risk stratify patients before doing so …”

Ophthalmic patients on antithrombotic drugs: a review and guide to perioperative management

“…This led the authors to suggest aspirin be continued during VR surgery but warfarin may be stopped in patients with low thromboembolic risk, each patient's circumstances being considered individually 11. However, two large studies12 13 concluded that continuation of anticoagulation does not add any significant risk of haemorrhage to the operation, recommending warfarin treatment is continued during vitrectomy surgery.…”

Bleeding statistics

“…I read with interest the recent work by Chandra et al and commend them for collecting such a group of patients, but I wish for clarification on a few points 1. They described the present work as a retrospective case–control study; I feel that this is incorrect.…”