title: Clopidogrel therapy in ophthalmic procedures: a survey of subspecialty ophthalmologists and review of current guidelines.
abstract: OBJECTIVE
  To assess the knowledge and practice of subspecialty ophthalmologists with respect to perioperative clopidogrel therapy in ophthalmic procedures.
  
  
  METHODS
  Mail survey composed of 5 questions.
  
  
  METHODS
  Fifteen subspecialty ophthalmologists (3 in each of the fields of surgical retina, anterior segment, oculoplastics, strabismus, and glaucoma) in 3 academic centers in Toronto, Ontario.
  
  
  METHODS
  Study parcipants completed an anonymous mail survey consisting of multiple-choice and short-answer questions. We studied participants' knowledge about and clinical practices regarding the use of clopidogrel in the perioperative period of specified ophthalmic procedures. We evalutated perceived risks of halting clopidogrel indicated for both primary and secondary prevention of cardiovascular events, as well as clinical decisions regarding clopidogrel in the perioperative period of specified ophthalmic procedures.
  
  
  RESULTS
  There was marked variability and relative lack of knowledge by subspecialty ophthalmologists in the management of clopidogrel in the perioperative period. Only 1 respondent identified coronary stent thrombosis or restenosis as a potential and life-threatening risk of halting clopidogrel therapy in these patients.
  
  
  CONCLUSIONS
  In patients with coronary stents, the risks of halting clopidogrel therapy in the perioperative period are potentially life-threatening and include stent thrombosis and myocardial infarction. Ophthalmic surgeons should pay close attention to the indications for clopidogrel therapy in their patients and should enlist appropriate collaboration with their colleagues in cardiology to minimize risks to their patients.
authors.affiliation: The University of Toronto Department of Ophthalmology & Vision Sciences, Toronto, Ont. tiiu.hess@utoronto.ca
authors.forename: Tiiu M
authors.initials: TM
authors.lastname: Hess
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Liu
mesh_terms: D000077144:Clopidogrel; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008511:Medicine; D013508:Ophthalmologic Surgical Procedures; D009885:Ophthalmology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic / Q000592:standards*; D013927:Thrombosis / Q000517:prevention & control; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine