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A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy.

Publication ,  Journal Article
Lane, RG; Jumper, JM; Nasir, MA; MacCumber, MW; McCuen, BW
Published in: Graefes Arch Clin Exp Ophthalmol
July 2005

BACKGROUND: To determine the maximum tolerated dose (MTD) of enoxaparin, a low molecular weight heparin (LMWH) was used during repeat vitrectomy for rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR) and severe diabetic retinopathy. METHODS: From 25 patients, 29 eyes undergoing repeat vitrectomy for PVR (CP3 or greater) or severe diabetic retinopathy were included in the study. Patients had previously undergone an average of 2.1 previous vitrectomies (range 1-5). Enoxaparin was added to the infusion fluid in an escalating dose from 0.1 IU/ml to 6.0 IU/ml as tolerated. Intraoperative bleeding, postoperative fibrin, hyphema and vitreous hemorrhage were graded in an unmasked fashion using previously described grading scales. RESULTS: All patients completed the study, and the study was able to achieve the 6.0 IU/ml maximum dose on the dose escalation schedule. No patient experienced dose-limiting toxicity. Analysis showed no increase in intraoperative bleeding complications between low dose (1.0 IU/ml) enoxaparin (Mann-Whitney Test, P=0.029). CONCLUSIONS: Enoxaparin dose escalation did not result in a dose-dependent increase in acute side effects. The establishment of a well-tolerated dose of enoxaparin during repeat vitrectomy for PVR and severe diabetic retinopathy (6.0 IU/ml) provides a foundation for future studies.

Duke Scholars

Published In

Graefes Arch Clin Exp Ophthalmol

DOI

ISSN

0721-832X

Publication Date

July 2005

Volume

243

Issue

7

Start / End Page

701 / 705

Location

Germany

Related Subject Headings

  • Vitreous Hemorrhage
  • Vitreoretinopathy, Proliferative
  • Vitrectomy
  • Reoperation
  • Prospective Studies
  • Ophthalmology & Optometry
  • Middle Aged
  • Maximum Tolerated Dose
  • Male
  • Intraoperative Complications
 

Citation

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ICMJE
MLA
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Lane, R. G., Jumper, J. M., Nasir, M. A., MacCumber, M. W., & McCuen, B. W. (2005). A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol, 243(7), 701–705. https://doi.org/10.1007/s00417-004-0912-0
Lane, R Gary, J Michael Jumper, Ma’an A. Nasir, Mathew W. MacCumber, and Brooks W. McCuen. “A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy.Graefes Arch Clin Exp Ophthalmol 243, no. 7 (July 2005): 701–5. https://doi.org/10.1007/s00417-004-0912-0.
Lane RG, Jumper JM, Nasir MA, MacCumber MW, McCuen BW. A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2005 Jul;243(7):701–5.
Lane, R. Gary, et al. “A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy.Graefes Arch Clin Exp Ophthalmol, vol. 243, no. 7, July 2005, pp. 701–05. Pubmed, doi:10.1007/s00417-004-0912-0.
Lane RG, Jumper JM, Nasir MA, MacCumber MW, McCuen BW. A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2005 Jul;243(7):701–705.
Journal cover image

Published In

Graefes Arch Clin Exp Ophthalmol

DOI

ISSN

0721-832X

Publication Date

July 2005

Volume

243

Issue

7

Start / End Page

701 / 705

Location

Germany

Related Subject Headings

  • Vitreous Hemorrhage
  • Vitreoretinopathy, Proliferative
  • Vitrectomy
  • Reoperation
  • Prospective Studies
  • Ophthalmology & Optometry
  • Middle Aged
  • Maximum Tolerated Dose
  • Male
  • Intraoperative Complications