Deep venous thrombosis after minor surgery.

摘要

We read with interest the article by Ong and coauthors describing a case of deep venous thrombosis (DVT) after uneventful phacoemulsification and the letter by Cannon in response. We would like to highlight prolonged postoperative bed rest and immobility as an additional risk factor for DVT after ocular surgery.Au Eong et al. report a case of pulmonary embolism from DVT in a 38-year-old white woman on the eighth day after retinal reattachment surgery with intravitreal gas injection and postoperative facedown head positioning. After the pulmonary embolism, screening for thrombophilia disclosed the patient had activated protein C resistance caused by factor V Leiden heterozygous mutation. Chu and Pince4 also report DVT in a patient 1 week after prone positioning after retinal reattachment surgery with intraocular gas tamponade. Deep venous thrombosis and pulmonary embolism, therefore, remain a major concern in patients requiring postoperative head positioning for prolonged duration. These patients may benefit from the use of silicone oil tamponade to reduce the need for postoperative head positioning in addition to other DVT prophylactic measures such as compression stockings, intermittent pneumatic compression, stretch exercises while in bed, and walking for 5 to 10 minutes every hour while maintaining the desired head posture.