Cataract surgery and anticoagulants

A questionnaire was sent to 240 members of the Netherlands Intraocular Implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye surgeons (76%) declared to discontinue anticoagulant therapy and the use of aspirin prior to cataract surgery, especially when using local anesthesia. After stopping anticoagulant therapy and the use of aspirin serious systemic complications were reported. Furthermore, ocular complications were reported due to continuation of ACT and the use of aspirin during surgery. Although the response rate to the enquiry was 32% only, we would suggest that continuation of ACT and the use of aspirin during surgery is to be recommended because of the possible life threatening complications related to discontinuing ACT and the use of aspirin. Risks of bleeding can be minimized further by using topical anesthesia, sub-tenon anesthesia and clear corneal surgery.