No need to stop warfarin during vitreoretinal procedures

Cessation of therapy with warfarin may not be necessary in patients receiving anticoagulation who are undergoing vitreoretinal procedures, according to a report in the March issue of Retina.

Arthur D. Fu, MD and colleagues from the California Pacific Medical Center, San Francisco, US, reviewed patient demographics, ocular findings and clinical courses from 25 patients receiving systemic anticoagulation with warfarin who subsequently underwent vitreoretinal surgery. Patients were aged between 49 and 81 years and indications for anticoagulation included atrial fibrillation, cerebrovascular disease, deep vein thrombosis, prosthetic heart valves and hypercoagulable state.

Mean follow-up period was 19.5 months (range 4-36 months) and the international normalized ratio ranged from 1.5 to 3.1. Final vision after surgery raged from 20/20 to 20/400. One patient, undergoing scleral buckling and external driniage of subretinal fluid, had an intraoperative subretinal haemorrhage. No other intraoperative complications occurred.

It was concluded that cessation of therapy with warfarin may not be necessary for patients undergoing vitreoretinal surgery and successful visual and anatomical results can still be achieved.