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Anticoagulation and cataract surgery
Yu-Chieh Hung1, Ainsley Morris1, Mark Elder1
1Department of Ophthalmology, Christchurch Hospital, Christchurch.
Insights
Continuing anticoagulation therapy, including warfarin and dabigatran, is safe for patients undergoing cataract surgery. This study found no significant increase in bleeding complications, suggesting current practices can be maintained.
Area of Science:
- Ophthalmology
- Cardiology
- Pharmacology
Background:
- Cataract surgery is a common procedure.
- Anticoagulation therapy is frequently prescribed for cardiovascular conditions.
- The safety of continuing anticoagulation during cataract surgery requires careful assessment.
Purpose of the Study:
- To evaluate the risk of hemorrhagic complications in patients undergoing cataract surgery while on anticoagulation.
- To compare outcomes between anticoagulated patients and a control group.
Main Methods:
- Retrospective audit of patients undergoing cataract surgery between January 2015 and December 2015.
- Inclusion of patients on warfarin or dabigatran.
- Comparison with a control group not on anticoagulation or antiplatelet therapy.
- Assessment of intraoperative and postoperative hemorrhage and thromboembolic events.
Main Results:
- Forty-four anticoagulated patients (warfarin or dabigatran) and 41 controls were included.
- Hemorrhagic complication rates were 18% (warfarin), 25% (dabigatran), and 11% (controls), with no statistical significance.
- Minor, non-visually significant hemorrhages were observed.
- No thromboembolic events occurred in any group.
Conclusions:
- Continuing anticoagulation with warfarin or dabigatran during cataract surgery does not lead to a statistically significant increase in hemorrhagic complications.
- The findings support the continuation of anticoagulation therapy in patients undergoing cataract surgery.
- Further research may explore optimal management strategies for anticoagulated patients.
Aim:
To assess the impact of anticoagulation on patients having cataract surgery.
Methods:
Patients who underwent cataract surgery with phacoemulsification and intraocular lens insertion between 1 January 2015 and 31 December 2015 at Christchurch Hospital were identified and retrospectively audited. The outcome measures were the occurrence of intraoperative and postoperative haemorrhage, and thromboembolic events within two weeks after surgery. A control group was included to assess the outcome measures in a sample of patients who were not on anticoagulants or antiplatelets.
Results:
Forty-four anticoagulated patients (46 eyes) and 41 controls (46 eyes) were identified. Seventy-four percent of those anticoagulated were on warfarin and 26% were on dabigatran. The incidence of haemorrhagic complications was 18%, 25% and 11% in the warfarin, dabigatran and control groups, respectively, although these differences were not statistically significant. Apart from one vitreous haemorrhage, which may have been present preoperatively, the haemorrhages that occurred were minor and not visually significant. No thromboembolic events were noted in any of the groups.
Conclusion:
There is no statistically significant increase in haemorrhagic complications in cataract surgery patients who were on warfarin or dabigatran. Therefore, continuing the anticoagulation in this setting may be appropriate.
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