The Use of Intravitreal Thrombin to Control Hemorrhage During Vitrectomy

The ability of intravitreal bovine thrombin to control intraoperative bleeding was investigated by a prospective double blind study of 28 consecutive patients with vascularized preretinal membranes undergoing vitrectomy for diabetic retinopathy. Addition of thrombin (100 units/ml) to the vitrectomy infusate was associated with a significantly reduced intraocular bleeding time after cutting vascularized membranes. The mean bleeding time without thrombin was 111.5 seconds, compared to 12.3 seconds with intravitreal thrombin (P < 0.0001). Patients receiving thrombin had less overall bleeding during surgery and less vitreous hemorrhage on the second postoperative day. Intravitreal bovine thrombin was associated with increased postoperative intraocular inflammation in 20% of patients receiving thrombin. This inflammation could be controlled by use of frequent topical steroids.