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Abstract #95344 Published in IGR 22-2

Update on the perioperative management of antiplatelets and anticoagulants in ophthalmic surgery

Herranz-Heras JC; Alcalde-Blanco L; Cañas-Zamarra I; Mencía-Gutiérrez E; Ferro-Osuna M; Pérez-Trigo S
Archivos de la Sociedad Espanola de Oftalmologia 2021; 96: 422-429

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INTRODUCTION: Anti-thrombotic drugs (antiplatelets and anticoagulants) are widely used for different clinical reasons. This means that there are an increasing number of patients undergoing elective ophthalmic surgery that are being treated with these drugs. A better knowledge of their implications and their peri-operative use may help to prevent surgical and secondary adverse events. There is often no firm recommendation on how to manage certain drugs in certain surgeries. OBJECTIVE: To review the recommendations in the scientific literature as regards managing anti-thrombotic agents during the peri-operative period of ophthalmic surgery. MATERIAL AND METHODS: A review was made of the relevant guidelines and studies using an antiplatelet and anticoagulant drugs approach for cataract, vitreo-retinal, glaucoma, oculoplastic, and strabismus surgeries. RESULTS: Recommendations about whether to continue or discontinue anti-thrombotic drugs in the peri-operative period of different ophthalmic surgical fields are presented. CONCLUSIONS: There are only firm recommendations of maintaining anti-thrombotic drugs as regards cataract surgery using phacoemulsification with topical anaesthesia. In other surgical fields, ophthalmologists should balance the risk of thromboembolic events and risks of haemorrhagic complications in order to carry out a proper management. A multi-disciplinary approach is recommended for complex cases. Additional studies should be performed to better characterise the peri-operative use of anti-thrombotic agents in order to prepare clinical guidelines for ophthalmic surgery.

Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain. Electronic address: jc.herranzh@gmail.com.

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