Managing antiplatelet and anticoagulant drugs in patients undergoing elective ophthalmic surgery

Kiire, Christine A.; Mukherjee, Raj; Ruparelia, Neil; Keeling, David; Prendergast, Bernard; Norris, Jonathan H.

doi:10.1136/bjophthalmol-2014-304902

Cited by 41 publications

(24 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Chronic anticoagulant/antiplatelet (AC/AP) medications have been involved in a statistically significant increase in the rate of both anesthesia related and surgery related intraoperative or postoperative bleeding complications including hyphaema, intrableb bleeding and suprachoroidal haemorrhage which can result in failure of the filtration procedure or loss of sight in patients undergoing glaucoma surgery. 38,39 Most of the glaucoma surgeons often require discontinuation of antiplatelet or anticoagulant (AC/AP) medications prior to glaucoma surgery, although there is little information available to offer definitive guidance with regard to discontinuation or continuation of AC/AP therapy. Anaesthesiologists should be aware of discontinuation of AC/AP therapy, because of the risk of thrombosis.…”

Section: Antiplatelet or Anticoagulant Medicationsmentioning

confidence: 99%

Anesthetıc Management in Glaucoma Surgery

Gedar¹,

Arı²,

Aykan³

2016

ARC Journal of Anesthesiology

View full text Add to dashboard Cite

Elevated intraocular pressure (IOP) causes structural changes in the optic nerve head in glaucoma patients. IOP reduction is clearly the only available treatment that has been proved to decrease both the risk of disease onset and its progression. Glaucoma surgery is indicated when maximal tolerated medical or laser therapy has failed to lower IOP. Anesthesia techniques for glaucoma surgery include general, retrobulbar, peribulbar, sub-Tenon's, subconjunctival, and topical anesthesia. General anesthesia may be advantageous for glaucoma surgery by avoiding the risks of regional anesthesia besides the total immobility of the patient, possibility to control the intraocular pressure, and the facility to fixate the operated eye. Anesthesiologists should be aware of the systemic side-effects and drug interactions of topical or systemic glaucoma medications. In addition, the effects of the anesthetic manoeuvers and drugs on IOP must be taken into consideration.

show abstract

Section: Antiplatelet or Anticoagulant Medicationsmentioning

confidence: 99%

Anesthetıc Management in Glaucoma Surgery

Gedar¹,

Arı²,

Aykan³

2016

ARC Journal of Anesthesiology

View full text Add to dashboard Cite

show abstract

“…This regimen has significantly reduced risks for morbidity and mortality due to vascular events. The potential benefit of aspirin and the low rate of adverse effects have made aspirin intaking fashionable in the elderly population [1–5]. Cataract surgery is one of the most common surgeries performed in elderly patients [6].…”

Section: Introductionmentioning

confidence: 99%

Continuation of Aspirin Therapy before Cataract Surgery with Different Incisions: Safe or Not?

Qian

Zhang

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To assess whether to continue aspirin therapy while having uncomplicated phacoemulsification cataract surgery with different incisions. Methods Consecutive patients having cataract surgery under topical anesthesia with different incisions between May 2016 and August 2017 were followed. 236 eyes of 166 patients on routine aspirin therapy were randomized into 2 groups: continuation group, 112 eyes; discontinuation group, 124 eyes. 121 eyes of 94 patients on no routine anticoagulant therapy were used as the control group. Patients were examined 1 day preoperatively and 1 day and 7 days postoperatively. Intraoperative and postoperative complications were recorded. Results Statistically, there was no significant difference about postoperative BCVA among three groups. A higher incidence of subconjunctival hemorrhage was shown in the continuation group than in the discontinuation group and the control group (17.0% versus 8.1%, p=0.038; 17.0% versus 7.4%, p=0.025, resp.). Although corneal edema was greater in clear corneal incision cases than that of scleral tunnel incision cases (22.5% versus 12.0%, p=0.009), subconjunctival hemorrhage was greater in scleral tunnel incision cases (14.9% versus 6.6%, p=0.011). Subgroup analyses revealed that patients of scleral tunnel incision who continued taking aspirin had a higher incidence of subconjunctival hemorrhage compared with those who discontinued (25.5% versus 10.9%, p=0.038), but no same conclusion in clear corneal incision cases (8.8% versus 5.0%, p=0.483). Conclusions The outcomes indicated that phacoemulsification cataract surgery under topical anesthesia could be safely performed without ceasing systemic aspirin therapy. Clear corneal incision could be a better choice in patients treated with aspirin.

show abstract

“…We believe that some issues presented in the article by Kiire et al 1 need to be corrected, and others deserve some further discussion.…”

mentioning

confidence: 96%