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Risk factors for bleeding and perioperative bleeding complications in oculoplastic surgery: a prospective pilot study
Nike Annika Christensen1, Nicolas Feltgen1, Maren Horn1
1Department of Ophthalmology, University Medical Center Göttingen, Goettingen, Germany.
The British Journal of Ophthalmology
|July 22, 2025
Summary
A standardized questionnaire effectively assesses bleeding risk in oculoplastic surgery patients on antiplatelet (AP) or anticoagulant (AC) therapy. This tool aids in managing perioperative bleeding complications, though further multicenter studies are recommended.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Hematology
Background:
- Managing patients on antiplatelet (AP) or anticoagulant (AC) therapy undergoing oculoplastic surgery lacks clear guidelines.
- This study addresses the need for effective bleeding risk assessment in extraocular surgeries.
Purpose of the Study:
- To investigate bleeding risk factors in oculoplastic surgery.
- To evaluate the effectiveness of a standardized bleeding risk assessment tool.
Main Methods:
- A prospective study utilized a standardized questionnaire (SQ) to collect bleeding histories.
- Associations between SQ scores, patient demographics, comorbidities, and surgical factors were analyzed.
- Bleeding severity was quantified, and patients were monitored postoperatively.
Main Results:
- Severe bleeding occurred in 35 of 324 patients; four required revision surgery.
- Higher SQ scores, acetylsalicylic acid use, diabetes, renal disease, general anesthesia, and longer surgery duration were associated with increased bleeding.
- Antiplatelet (AP) or anticoagulant (AC) use, local anesthesia, and systolic hypertension were not significantly linked to bleeding risk.
Conclusions:
- The standardized questionnaire (SQ) is a valuable tool for assessing bleeding risk in oculoplastic surgery.
- Findings support developing evidence-based perioperative guidelines for AP and AC management.
- Further multicenter studies are recommended, acknowledging limitations such as cohort heterogeneity and subjective scoring.
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