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Hemorrhagic complications from glaucoma surgery in patients on anticoagulation therapy or antiplatelet therapy

Simon K Law1, Brian J Song, Fei Yu

  • 1Jules Stein Eye Institute, UCLA, Los Angeles, California 90095, USA. law@jsei.ucla.edu

American Journal of Ophthalmology
|February 8, 2008
PubMed

Insights

Patients on anticoagulation (ACT) or antiplatelet therapy (APT) undergoing glaucoma surgery face higher risks of hemorrhagic complications. Continuing ACT during surgery significantly increases this risk, alongside high intraocular pressure.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Vascular Surgery

Background:

  • Glaucoma surgery requires careful consideration of patient comorbidities and medications.
  • Anticoagulation (ACT) and antiplatelet therapy (APT) are commonly used for cardiovascular and cerebrovascular protection.
  • The risk of bleeding complications must be balanced against the risk of thromboembolic events in patients on ACT/APT undergoing surgery.

Purpose of the Study:

  • To investigate the incidence of hemorrhagic complications in patients undergoing glaucoma surgery who are on ACT or APT.
  • To identify risk factors associated with hemorrhagic complications in this patient population.

Main Methods:

  • Retrospective case-control study analyzing medical records of glaucoma surgery patients.
  • Comparison of patients on continuous ACT/APT with control patients not on these therapies.
  • Analysis of outcomes including hemorrhagic complications and thromboembolic events.

Main Results:

  • Patients on ACT/APT had a significantly higher rate of hemorrhagic complications (10.1%) compared to controls (3.7%).
  • Anticoagulation therapy (ACT) was associated with a higher complication rate than antiplatelet therapy (APT) (22.9% vs 8.0%).
  • Continuing ACT during surgery led to the highest complication rate (31.8%), with preoperative ACT, arrhythmia, and high intraocular pressure (IOP) identified as risk factors.

Conclusions:

  • Chronic use of ACT/APT significantly increases the risk of hemorrhagic complications after glaucoma surgery.
  • Perioperative ACT and elevated preoperative IOP are identified as key risk factors for these complications.
Abstract

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