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Master Thesis

L'aspirine n'est pas un facteur de risque de complications hémorragiques pendant et après une première chirurgie de décollement de rétine rhegmatogène

Abstract : Objective: To evaluate the hemorrhagic risk of treatment by acetylsalicylic acid, during the management of primary rhegmatogenous retinal detachment (RD). Design: case-control study (according to presence of perioperative bleeding complications). Participants: 322 patients (322 eyes) from a prospective cohort of 835 patients with primary rhegmatogenous RD operated on between 2004 and 2007. Methods: After exclusion of patients with RD secondary to trauma, subjects with a history of vitreoretinal surgery, diabetic retinopathy, aphakia or taking clopidogrel and/or a vitamin K antagonist, 74 patients were included in the hemorrhagic group and patients without hemorrhagic complications were randomly selected in order to reach a 1:3 case: control population. Univariate and multivariate analyses were performed to identify risk factors of perioperative bleeding. Main outcome measures: Occurrence of hemorrhagic complications such as hyphema and intravitreal, subretinal and suprachoroidal hemorrhage. Prognostic factors included final visual acuity (LogMAR) and the single-operation attachement rate. Results: Univariate analysis showed that the presence of initial vitreous hemorrhage, size of breaks, number of breaks, pars plana vitrectomy (PPV) and the number of cryotherapy impacts were significantly associated with perioperative bleeding. Independent risk factors of perioperative hemorrhage were the number of cryotherapy sessions (odds ratio =1.12 [1.06; 1.20], 95% CI), transscleral drainage (OR =4.22 [1.62; 10.98]), and 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, and final visual acuity. Conclusion: Aspirin was not an independent risk factor of hemorrhagic complications during and after surgery of primary rhegmatogenous RD. The bleeding risk is instead associated with surgical factors such as PPV, cryotherapy, and subretinal fluid drainage.
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Master Thesis
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Submitted on : Monday, September 5, 2011 - 3:26:11 PM
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  • HAL Id : dumas-00619132, version 1
  • PPN : 154698342


Eva Zaratzian Brillat. L'aspirine n'est pas un facteur de risque de complications hémorragiques pendant et après une première chirurgie de décollement de rétine rhegmatogène. Médecine humaine et pathologie. 2011. ⟨dumas-00619132⟩



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