Materials and Methods: We included subjects using anticoagulant and/or antiplatelet treatment and who had undergone cataract surgery with PE using a clear corneal incision in the study. The age, gender, reason for anticoagulant/antiplatelet treatment, preoperative drug strategy and hemorrhagic complications were assessed.
Results: The 158 patients (mean age 70.79±7.87 years; min-max 51-92 years) consisted of 80 males and 78 females. The anticoagulant/ antiplatelet treatment consisted of acetylsalicylic acid (ASA) in more than two-thirds (69.62%), followed by clopidogrel (10.75%) and warfarin (9.49%). The treatment was continued before PE in more than 90% of patients taking ASA while most warfarin and clopidogrel users were started on temporary low molecular weight heparin (LMWH) treatment. Subconjunctival hemorrhage developed in 5 patients during surgery (2 patients using ASA, 2 using LMWH following warfarin and 1 with stopped clopidogrel treatment). Anterior chamber hemorrhage developed in 2 patients who were using temporary LMWH following warfarin. No complications were encountered in patients using Dabigatran or Rivaroxaban.
Conclusion: PE surgery under topical anesthesia following antiplatelet use is safe. Safe PE can be ensured in warfarin users by temporary use of LMWH keeping the International Normalized Ratio at a therapeutic level. For patients using new generation anticoagulants, we recommend stopping the medication 24 hours before surgery to be continued 24 hours after the end of surgery.
Keywords : Anticoagulant drugs, antiplatelet drugs, phacoemulsifi cation surgery, hemorrhage, cataract