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Anticoagulation therapy and ocular surgery

A K Saitoh1, A Saitoh, H Taniguchi

  • 1Department of Ophthalmology, Nagasaki University School of Medicine, Japan.

Ophthalmic Surgery and Lasers
|November 24, 1998
PubMed
Summary
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Ocular surgery in patients on anticoagulant therapy can be managed without stopping medication, but stopping ticlopidine hydrochloride may prevent hemorrhagic complications during cataract surgery.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Pharmacology

Background:

  • Ocular surgery in patients on anticoagulant therapy lacks clear management guidelines.
  • Anticoagulant therapy is common in patients undergoing ocular procedures.

Purpose of the Study:

  • To examine complications in patients receiving anticoagulant therapy during ocular surgery.
  • To suggest a management regimen for these patients.

Main Methods:

  • Retrospective analysis of 52 patients on anticoagulant therapy undergoing ocular surgery (1993-1995).
  • Data collected included patient demographics, anticoagulant type, surgical procedure, and complication rates.
  • Comparison with a control group not receiving anticoagulation.

Main Results:

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  • No significant difference in complications between groups who stopped/reduced anticoagulation and those who did not.
  • Stopping ticlopidine hydrochloride was associated with fewer hemorrhagic complications (0% vs. 50%, P = .019).
  • Phacoemulsification, aspiration, and intraocular lens implantation (PEA + IOL) showed fewer hemorrhagic complications than planned extracapsular cataract extraction and intraocular lens implantation (PECCE + IOL) when ticlopidine was continued (P = .0011).

Conclusions:

  • Anticoagulant therapy may not always require cessation for cataract surgery to prevent systemic complications.
  • Cataract surgery with PEA + IOL using small incisions is recommended for patients on ticlopidine hydrochloride.
  • Hemorrhagic complications are more frequent in patients on anticoagulant therapy undergoing cataract surgery compared to controls.