Anticoagulation and cataract surgery

Abstract

Aim: To assess the impact of anticoagulation on patients having cataract surgery.

Methods: Patients who underwent cataract surgery with phacoemulsification and intraocular lens insertion between 1 January 2015 and 31 December 2015 at Christchurch Hospital were identified and retrospectively audited. The outcome measures were the occurrence of intraoperative and postoperative haemorrhage, and thromboembolic events within two weeks after surgery. A control group was included to assess the outcome measures in a sample of patients who were not on anticoagulants or antiplatelets.

Results: Forty-four anticoagulated patients (46 eyes) and 41 controls (46 eyes) were identified. Seventy-four percent of those anticoagulated were on warfarin and 26% were on dabigatran. The incidence of haemorrhagic complications was 18%, 25% and 11% in the warfarin, dabigatran and control groups, respectively, although these differences were not statistically significant. Apart from one vitreous haemorrhage, which may have been present preoperatively, the haemorrhages that occurred were minor and not visually significant. No thromboembolic events were noted in any of the groups.

Conclusion: There is no statistically significant increase in haemorrhagic complications in cataract surgery patients who were on warfarin or dabigatran. Therefore, continuing the anticoagulation in this setting may be appropriate.