Intravitreal low molecular weight heparin in PVR surgery

Indian J Ophthalmol. 2003 Mar;51(1):67-70.

Abstract

Purpose: To evaluate the efficacy of low molecular weight heparin (LMWH) in prevention of postoperative fibrin formation following vitreoretinal surgery with proliferative vitreoretinopathy (PVR).

Material and methods: Thirty consecutive patients of retinal detachment with advanced PVR were enrolled in the study. They were randomised to study and control groups (n = 15 each). Study group patients received vitreoretinal surgery with 5 IU/cc of LMWH in vitrectomy infusion fluid. The control group patients received vitroretinal surgery without heparin in the infusion fluid. Patients were followed up at 1 week, 1 month and 3 months after surgery. Postoperative bleeding, media clarity, best-corrected visual acuity and success of the surgery at the end of 3 months were compared between the two groups.

Results: At each follow-up visit, the study group showed a better media clarity, which was statistically significant (P = 0.0042). The study group had a 50% better chance of retinal reattachment compared to the control group. Five patients had intraoperative bleeding in the study group (33%) compared to 3 patients in the control group (20%).

Conclusion: Use of intravitreal LMWH prevents postoperative fibrin formation and is beneficial in repair of retinal detachments with PVR.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Fibrin / drug effects*
  • Fibrinolytic Agents / therapeutic use*
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retinal Detachment / surgery*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / methods*
  • Vitreoretinopathy, Proliferative / surgery*

Substances

  • Fibrinolytic Agents
  • Heparin, Low-Molecular-Weight
  • Fibrin