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Munir Iqbal, Lisa Jagan, Jeff Gale, David Almeida; Morbidity and Mortality in Vitreoretinal Surgery Following Post-Operative Positioning. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2206.
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Venous thromboembolisms (VTE) are an important subject of research due to their preventable nature and potentially fatal consequences. Postoperative immobilization is a significant risk factor VTE, and while most ophthalmic surgeries are ambulatory in nature, many vitreoretinal (VR) surgeries require patients to maintain specific positioning for up to several weeks postoperatively. Despite the consensus on the importance of early postoperative mobilization, to date, there is not sufficient data documenting the incidence of VTE following VR surgery. The goal of this study is to quantify the incidence of VTEs attributable specifically to prolonged immobilization following VR surgery.
We included patient charts from a retina clinic in a single tertiary-care centre (Kingston, Ontario, Canada). The study group consisted of patients that underwent repair of retinal detachments or macular holes that required injection of intravitreous gas and subsequent positioning. The control group consisted of patients that underwent epiretinal membrane removal or pars plana vitrectomy for vitreous hemorrhage and did not require any postoperative positioning. Events of post-operative VTEs and/or death within a 4 week period were documented. Demographic data were gathered through hospital records, while data regarding complications were gathered by contacting patients, family members and their family doctors.
We included data from 146 patients, 74 of whom were in the study group and 72 in the control group. No complications were observed in either of the two groups. In a comparison of gender and age distribution among the patients, we noted that there was a statistically significant difference in age between patients who required postoperative positioning compared to those that did not (mean=64.9 cf. mean=68.3 years, p=0.044).
There was no significant difference in the rates of VTE and death between the two study groups and no significant complications were attributed to postoperative positioning after VR surgery. This is a novel study directly assessing complications in the context of positioning after VR surgery.
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