A Comparative Study of Ocular Hemorrhage in Cataract Surgery Patients Receiving Continuous Antithrombotic and with Preoperative Discontinuation
Keywords:
cataract surgery, antiplatelet, anticoagulant, complicationAbstract
Objective: To compare the incidence of ocular hemorrhage in cataract surgery between patients who continue
antithrombotic and with preoperative discontinuation.
Method: A retrospective cohort study of patients who on antiplatelet or anticoagulant drugs undergoing cataract
surgery between January 2020 and December 2020 were eligible in the study. Patients discontinued antithrombotic drugs
5-7 days before surgery (discontinuation group) or continued therapy until the time of surgery (maintenance group).
Patients were examined 1 day, 7 days and 1 month postoperatively. Intraoperative and postoperative ocular bleeding and
systemic complications were assessed.
Main outcome measures: Intraoperative and postoperative ocular hemorrhage and thromboembolic complications.
Results: 288 eyes of 274 patients were included in the study. The maintenance antiplatelet/anticoagulant group
comprised 115 eyes, the discontinuation group comprised 173 eyes. There was no sight threatening intraoperative bleeding.
Sixty-eight eyes (40.5%) in the discontinuation antiplatelet group and twenty-six eyes (24.5%) in the maintenance
antiplatelet group had subconjunctival hemorrhages (p=0.01), associated with local anesthesia (OR 48.78, 95%CI 18.45-128.97). Using multivariable analysis, maintenance antiplatelet did not increase risk of subconjunctival hemorrhage (OR
0.55, 95%CI 0.27-1.11). There was no significant difference regarding hemorrhages between the discontinuation and the
maintenance group in anticoagulant and dual antiplatelet therapy. During the 1-month postoperative period, patient in the
discontinuation and the maintenance antiplatelet group had thromboembolic complication 1 case in each group.
Conclusions: Minor ocular hemorrhage occurred 34% of eyes, with no significant difference between discontinuation
and maintenance antiplatelet. There was no significant difference in the incidence of sight threatening hemorrhage and
systemic complications.
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The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
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