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J Cataract Refract Surg. 2011 Aug;37(8):1434-8. doi: 10.1016/j.jcrs.2011.02.035. Epub 2011 Jun 17.

Risk assessment of simple phacoemulsification in patients on combined anticoagulant and antiplatelet therapy.

Author information

  • 1Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. ibarequet@hotmail.com

Abstract

PURPOSE:

To assess the safety of phacoemulsification cataract extraction in patients on combined anticoagulant and antiplatelet treatment.

SETTING:

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.

DESIGN:

Prospective interventional case series.

METHODS:

Consecutive patients with simple cataract on combined anticoagulant (warfarin) and antiplatelet (aspirin or clopidogrel) treatment who were unable to discontinue the treatment because of a high risk for thromboembolic events were included. Patients had cataract extraction under topical anesthesia with a clear corneal incision (CCI), phacoemulsification, and implantation of a foldable posterior chamber intraocular lens. Prothrombin time-international normalized ratio and platelet functions were evaluated immediately before surgery. Patients were also examined 1 day and 7 days postoperatively. Intraoperative and postoperative ocular bleeding and other related complications were assessed.

RESULTS:

Forty patients (51 eyes) with a mean age of 72 years (range 51 to 90 years) had phacoemulsification. Hemorrhagic complications were not observed at surgery or during the 1-week follow-up. Surgical complications included 1 rupture of the capsulorhexis and 1 implantation of a capsular tension ring due to partial zonulysis. No patient had a thromboembolic event.

CONCLUSIONS:

In patients with uncomplicated cataract at high risk for thromboembolic events, phacoemulsification cataract surgery using a CCI under topical needle-free anesthesia was safely performed without discontinuing systemic anticoagulant and antiplatelet treatment.

Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

PMID:
21684111
[PubMed - indexed for MEDLINE]
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