title: Hemorrhagic complications from glaucoma surgery in patients on anticoagulation therapy or antiplatelet therapy.
abstract: OBJECTIVE
  To determine the incidence of and risk factors for hemorrhagic complications in patients on anticoagulation (ACT) or antiplatelet therapy (APT) having glaucoma surgery.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Medical records of patients who had glaucoma surgery between July 1, 1998 and March 31, 2005 were reviewed. Patients who either used ACT/APT continuously throughout the perioperative period or discontinued its use prior to surgery were compared to case-matched control patients who were not on such therapies. Patients on ACT/APT who experienced postoperative hemorrhagic complications were compared to those who did not. Outcome measures included hemorrhagic complications and thromboembolic events.
  
  
  RESULTS
  Three hundred and forty-seven patients (eyes) who were on ACT or APT prior to glaucoma surgery had a higher rate of hemorrhagic complications than 347 control patients (10.1% vs 3.7%, respectively, P = .002). Patients on ACT had a higher rate of hemorrhagic complications than patients on APT (22.9% vs 8.0%, respectively, P = .003). Patients who continued ACT during glaucoma surgery had the highest rate of hemorrhagic complications (31.8%) when compared to patients who discontinued ACT prior to surgery or patients who used APT alone (P = .001). Hemorrhagic complications following glaucoma surgery were more frequently associated with preoperative ACT, arrhythmia, and higher preoperative and postoperative intraocular pressures (IOP).
  
  
  CONCLUSIONS
  Chronic ACT/APT was associated with a statistically significant increase in the rate of hemorrhagic complications, and perioperative ACT and a high preoperative IOP are potential risk factors for hemorrhagic complications in patients undergoing glaucoma surgery.
authors.affiliation: Jules Stein Eye Institute, UCLA, Los Angeles, California 90095, USA. law@jsei.ucla.edu
authors.forename: Simon K
authors.initials: SK
authors.lastname: Law
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Song
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Kristina
authors.initials: K
authors.lastname: Kurbanyan
authors.forename: Tien-An
authors.initials: TA
authors.lastname: Yang
authors.forename: Joseph
authors.initials: J
authors.lastname: Caprioli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D005130:Eye Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D015994:Incidence; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014130:Trabeculectomy; D014792:Visual Acuity
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors