PMID- 35493972
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230328
IS  - 1177-5467 (Print)
IS  - 1177-5483 (Electronic)
IS  - 1177-5467 (Linking)
VI  - 16
DP  - 2022
TI  - Risk Factors for Severe Bleeding Complications in Glaucoma Surgery and the Role 
      of Antiplatelet or Anticoagulant Agents.
PG  - 1245-1254
LID - 10.2147/OPTH.S361867 [doi]
AB  - PURPOSE: To evaluate the influences and risk factors for severe bleeding 
      complications during glaucoma surgery, and to investigate the role of 
      antiplatelet (AP) and anticoagulant (AC) agents. METHODS: This prospective study 
      enrolled patients undergoing trabeculectomy, trabeculotomy (with Trabectome(R) or 
      Kahook Dual Blade(R)), viscocanaloplasty and Ahmed or Baerveldt implants. Bleeding 
      severity was graded on an ordinal scale ranging from 0 to 5. Immediately after 
      surgery and one day later, the incidence and severity of bleeding events was 
      documented on a standardized form. A grade >/=3 was defined as severe bleeding. The 
      influence of known systemic disorders, the type of anesthesia, surgical 
      procedure, intraoperative blood pressure, and the use of or change in AP or AC 
      agents on intraoperative bleeding were analyzed. RESULTS: Data from 89 eyes 
      undergoing glaucoma procedures were included (age 71.3y +/- 10.5). We observed 
      severe intraoperative bleeding in 8 eyes (9%) and found that concomitant diseases 
      such as the history of a deep vein thrombosis or peripheral arterial occlusive 
      disease, and the type of surgical procedure (trabeculectomy and 
      viscocanaloplasty) were significantly associated with severe bleeding events. By 
      contrast, the use of AP/ AC agents had no significant influence on severe 
      intraoperative bleeding events. CONCLUSION: According to the results of our study 
      cohort, glaucoma procedures entailing scleral manipulations (trabeculectomy and 
      viscocanaloplasty) and concomitant diseases such as the history of a deep vein 
      thrombosis or peripheral arterial occlusive disease influence the risk of severe 
      intraoperative bleeding events, we detected no increased risk related to 
      concomitant antiplatelet and/ or anticoagulant medication use.
CI  - (c) 2022 Lauermann et al.
FAU - Lauermann, Peer
AU  - Lauermann P
AUID- ORCID: 0000-0003-3597-3219
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - Klingelhofer, Anthea
AU  - Klingelhofer A
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - Mielke, Dorothee
AU  - Mielke D
AD  - Department of Neurosurgery, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - Bahlmann, Dirk
AU  - Bahlmann D
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - Hoerauf, Hans
AU  - Hoerauf H
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - Koscielny, Juergen
AU  - Koscielny J
AD  - Gerinnungsambulanz mit Hamophiliezentrum im Ambulanten Gesundheitszentrum (AGZ), 
      Charite Universitatsmedizin Berlin, Berlin, Germany.
FAU - Sucker, Christoph
AU  - Sucker C
AD  - COAGUMED Coagulation Center, Berlin, Germany.
FAU - Feltgen, Nicolas
AU  - Feltgen N
AUID- ORCID: 0000-0002-6857-3003
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
FAU - van Oterendorp, Christian
AU  - van Oterendorp C
AD  - Department of Ophthalmology, University Medical Center Goettingen, Goettingen, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20220422
PL  - New Zealand
TA  - Clin Ophthalmol
JT  - Clinical ophthalmology (Auckland, N.Z.)
JID - 101321512
PMC - PMC9041781
OTO - NOTNLM
OT  - anticoagulant agents
OT  - antiplatelet agents
OT  - glaucoma surgery
OT  - severe bleeding complications
COIS- Adj. Prof. Dr. J. Koscielny: speaker honoraria from Aspen, Bayer Health Care 
      Pharmaceuticals, Biotest, Chugai, Daiichi Sankyo, Boehringer Ingelheim, CSL 
      Behring, Pfizer, LFB, BMS, Mitsubishi, Roche, Sanofi, Novo Nordisk, and Shire 
      (Takeda). Adj. Prof. Dr. Koscielny is also a medical advisor for CSL Behring 
      International, Bayer HealthCare Pharmaceuticals (national and international), and 
      Novo Nordisk (national). He reports grants from Biomarin. Prof. Dr. Nicolas 
      Feltgen reports grants and/or personal fees for speaker, advisory boards, and/or 
      clinical studies from Novartis, Bayer, Allergan, Alimera, Roche, and Heidelberg, 
      outside the submitted work. The authors report no other conflicts of interest in 
      this work.
EDAT- 2022/05/03 06:00
MHDA- 2022/05/03 06:01
PMCR- 2022/04/22
CRDT- 2022/05/02 06:26
PHST- 2022/02/22 00:00 [received]
PHST- 2022/04/06 00:00 [accepted]
PHST- 2022/05/02 06:26 [entrez]
PHST- 2022/05/03 06:00 [pubmed]
PHST- 2022/05/03 06:01 [medline]
PHST- 2022/04/22 00:00 [pmc-release]
AID - 361867 [pii]
AID - 10.2147/OPTH.S361867 [doi]
PST - epublish
SO  - Clin Ophthalmol. 2022 Apr 22;16:1245-1254. doi: 10.2147/OPTH.S361867. eCollection 
      2022.