gms | German Medical Science

Background: Patients suffering from vasoproliferative retinopathy and vitreoretinal hemorrhage face much higher surgery risks due to their age and comorbidities. Goal of this clinical study is to evaluate pre- and intrasurgical parameters (age, sex, ASA-Classification, surgery duration, accompanying diseases) in order to perform a risk evaluation concerning vitreoretinal surgery.

Methods: In a prospective examination data of 46 patients with vitreoretinal hemorrhage and vasoproliferative retinopathy, who had undergone a vitreoretinal surgery with endotracheal anesthesia, was gathered. Influence of ASA-criteria and accompanying diseases onto the pre-, intra- and postsurgical process was analyzed.

Results: In average the age of the patients was 66 years and 2.4 internistic accompanying diseases were present. 88% of all patients belonged to ASA groups II and III, and 9.3% even belonged to risk group IV. Only 2.3% belonged to the lower risk ASA group I. Concerning the evaluation of surgery duration and postsurgical complications there were no differences between members of ASA groups II and III (average surgery duration: 83 min.). 5 patients (11%) suffered from kidney insufficiency, requiring dialysis and 2 patients (4%) had to be treated internistically after the surgery. In one case a patient suffered from myocardial infarction without lethal consequences post surgically.

Conclusions: Patients suffering from vitreous hemorrhage and vasoproliferative retinopathy belong to risk groups, being distinguished by multimorbidity and elevated ASA-criteria. Due to the perioperative morbidity an adequate interdisciplinary and postoperative intensive medical care is necessary.