The Impact of the Menstrual Cycle on Perioperative Bleeding in Vitreoretinal Surgery

Purpose. To investigate the effect of menstrual cycle on perioperative bleeding of primary vitreoretinal surgery. Methods. Data on female patients who had vitrectomy surgery was retrospectively collected. Exclusion criteria were history of trauma, vitreous hemorrhage, previous vitreoretinal surgery, diabetic retinopathy, endophthalmitis, acute retinal necrosis, single vitreous opacity, and use of antiplatelet agents. Perioperative bleeding was defined as hemorrhage in the iris, vitreous, choroidal, retina, or subretina during surgery or up to one day postoperatively. 69 patients had surgery during the perimenstrual phase (group M, days 1-7 and days 21-28) and 86 during periovulatory phase (group O, days 8-20) were enrolled. Results. The proportion of operative bleeding in group M (14.5%) and group O (10.5%) was not found to be significantly different (p = 0.45). No postoperative bleeding was recorded in both groups. The univariate odds ratio (OR) and 95% confidence interval (CI) of perimenstrual phase for operative bleeding were 0.69 (0.26-1.81). After adjusting for patients' age, vitreoretinal diseases, and surgeons, the multivariate OR and 95% CI were 0.71 (0.27-1.86). Conclusion. This study suggests that the timing of the menstrual period does not affect perioperative bleeding for primary vitreoretinal surgery. Menstruation appears not to be a contraindication for vitreoretinal surgery.