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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.

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



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


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


Prospective interventional case series.


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.


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.


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.

[PubMed - indexed for MEDLINE]
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