Perioperative Evaluation after Cataract Surgery in Patients Taking Antithrombotic Medication

Kim, Hae Rang; Pak, Kang Yeun

Original Article

Annals of Optometry and Contact Lens 2019;18(3):75-80.
Published online September 25, 2019.

Perioperative Evaluation after Cataract Surgery in Patients Taking Antithrombotic Medication

Hae Rang Kim, Kang Yeun Pak

Department of Ophthalmology, Inje University Haeundae Paik Hospital, Busan, Korea

Received: 27 March 2019 • Revised: 16 July 2019 • Accepted: 7 August 2019

Abstract

Purpose: To investigate outcomes and complications of cataract surgery using clear corneal incision in patients taking antithrombotic medication.
Methods: We reviewed medical records of 156 eyes of 103 patients taking antithrombotic medication who underwent cataract surgery from January 2011 to July 2017. Patients underwent standard phacoemulsification through clear corneal incision, and topical anesthesia was performed before the surgery. The patients were divided into two groups based on the adjustment in medication: the continuation group (group C) and the discontinuation group (group D). The primary outcome was the incidence of hemorrhagic and thromboembolic complications, and the secondary outcomes were the change in best corrected visual acuity (BCVA) and incidence of perioperative ocular complications.
Results: The mean patient age was 69.7 ± 12.9 years and the proportion of female patients was 64.1% (66/103). Forty-five eyes were being treated with anticoagulants, 87 eyes with antiplatelet agents, and 24 eyes with a combined treatment. Group C comprised 68 eyes and group D comprised 88 eyes. There were no instances of serious hemorrhagic or thromboembolic complications in either group. In both groups, the BCVA increased significantly at one month after surgery (0.75 ± 0.81 to 0.18 ± 0.24 logMAR and 0.73 ± 0.71 to 0.26 ± 0.33 logMAR; p = 0.004 and 0.020, respectively) with no significant difference (p = 0.979). There was no significant difference between groups in the incidence of ocular complications such as posterior capsule rupture, corneal edema, and intraocular pressure elevation.
Conclusions: Patients taking antithrombotic medication could safely undergo cataract surgery without major complications regardless of the discontinuation of medication.

Key Words: Anticoagulants or antiplatelet agents; Cataract extraction; Clear corneal incision; Perioperative complication