Aspirin Is Not A Risk Factor Of Bleeding Complications During Or After Primary Rhegmatogenous Retinal Detachment Surgery

Abstract

Purpose: : To evaluate the hemorrhagic risk of treatment by acetylsalicylic acid (aspirin) during the management of primary rhegmatogenous retinal detachment (RD).

Methods: : This case-control study included 322 patients from a prospective cohort (2004 - 2007). After exclusion of 109 patients (trauma, an history of vitreoretinal surgery, diabetic retinopathy, aphakia or taking clopidogrel and/or a vitamin K antagonist), the cohort of 726 patients allowed to define the hemorrhagic group (n=74) and the non hemorrhagic group (control group: three random cases for one hemorrhagic case, n=248). Univariate and multivariate analyses were performed to identify risk factors of perioperative bleeding. Main outcome measures were occurrence of hyphema and intravitreal, subretinal and suprachoroidal hemorrhage, final visual acuity (VA, LogMAR) and the retinal reattachment rate.

Results: : Independent risk factors of perioperative hemorrhage were the number of cryotherapy impacts (odds ratio =1.12 [1.06; 1.20], 95% confidence interval), transscleral drainage (OR =4.22 [1.62; 10.98]), and use of PPV (OR =3.39 [1.36; 8.47]). The occurrence of bleeding complications was associated with a lower single-operation anatomical success rate. There was also a trend toward an association between bleeding complications, the total number of RD recurrences (0.2 ± 0.5 in the non bleeding group vs 0.2 ± 0.5 in the bleeding group, p=0.06), and final VA (0.6 ± 0.7 vs 0.7 ± 0.7, p=0.09).

Conclusions: : Aspirin was not an independent risk factor of hemorrhagic complications during and after surgery of primary rhegmatogenous RD. Perioperative bleeding is instead associated with surgical factors and leads to a lower single-operation anatomic success rate.

Keywords: retinal detachment • clinical (human) or epidemiologic studies: risk factor assessment