[Cataract surgery under topical anesthesia with oral anticoagulants].
BACKGROUND
Approximately 14 % of cataract surgery patients receive blood-thinning agents. In a prospective study, the influence of oral anticoagulants on intraoperative and postoperative hemorrhages in patients undergoing cataract surgery in topical anesthesia was investigated.


METHODS
128 patients presenting for cataract surgery under oral anticoagulation were included. The mean preoperative prothrombin time was 39 +/- 18 %. Most patients (81 %) continued their oral anticoagulation (prothrombin time 34 +/- 13 %). All surgeries were performed in topical anesthesia.


RESULTS
In 9 patients (7 %) an ocular hemorrhagic event was observed. These were not sight-threatening and resorbed spontaneously within a few days. Only one patient (0.8 %) had a slight hemorrhage in the anterior chamber. There were no differences (P > 0.05) between patients with or without hemorrhagic complications in the postoperative visual acuity, the intraocular pressure, the prothrombin time or the discontinuation of oral anticoagulants.


CONCLUSIONS
Cataract surgery in topical anesthesia under oral anticoagulation did not increase the risk of sight-threatening hemorrhages. The continuation of oral anticoagulation seems particularly indicated for ambulatory cataract surgery.
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin. christopher.wirbelauer@vivantes.de
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D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D005130:Eye Hemorrhage / Q000209:etiology*; D005260:Female; D006801:Humans; D007267:Injections; D007431:Intraoperative Complications / Q000209:etiology*; D007910:Lenses, Intraocular; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011343:Procaine / Q000031:analogs & derivatives*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014792:Visual Acuity
D000925:Anticoagulants; D009883:Ophthalmic Solutions; D011343:Procaine; D008012:Lidocaine; C005298:benoxinate