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Article: Phacoemulsification cataract surgery in patients receiving novel oral anticoagulant medications

TitlePhacoemulsification cataract surgery in patients receiving novel oral anticoagulant medications
Authors
KeywordsCataract
Haemorrhagic complication
NOAC
Non-vitamin K antagonist oral anticoagulants
Novel oral anticoagulant
Perioperative
Phacoemulsification
Issue Date2018
PublisherSpringer Verlag Dordrecht. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=0165-5701
Citation
International Ophthalmology, 2018, p. 1-8 How to Cite?
AbstractINTRODUCTION: An increasing number of patients are taking novel oral anticoagulant (NOAC) medication, making perioperative management in phacoemulsification surgery an important issue. This study reports the haemorrhagic complications of NOAC in phacoemulsification surgery. DESIGN: Retrospective case study over a 4-year period. METHODS: Consecutive cases receiving NOAC during the time of phacoemulsification were reviewed. Patients were either advised to continue medications (continued group) or withhold medications before surgery (withheld group). MAIN OUTCOME MEASURES: Details including patient demographics, preoperative assessment, postoperative outcome and intraoperative, postoperative and systemic complications were recorded. RESULTS: A total of 20,100 cases of phacoemulsification were performed. Of which, 66 cases were found to be on NOAC (0.33%). This included 66 eyes of 53 patients, with 42 continued and 24 withheld medications before surgery. There was no statistically significant difference between the two groups in demographics, cataract risk factors, baseline renal function, clotting profile, type of NOAC, incision size, phacoemulsification energy, preoperative and postoperative visual acuity. There was also no significant difference in intraoperative, postoperative and systemic complications (p = 1.00 and 0.53, Fischer's exact test). None of the patients in the continued group had postoperative complications; two cases in the withheld group receiving retrobulbar anaesthesia had bruising and subconjunctival haemorrhage after resumption of NOAC (p = 0.13, Fischer's exact test). CONCLUSION: The present study found no difference in haemorrhagic complications between cases continuing and withholding NOAC during phacoemulsification. Nevertheless, the potential risks and benefits to continue or withhold NOAC perioperatively should be carefully considered via a multidisciplinary approach.
Persistent Identifierhttp://hdl.handle.net/10722/258482
ISSN
2019 Impact Factor: 1.314
2015 SCImago Journal Rankings: 0.526

 

DC FieldValueLanguage
dc.contributor.authorCheung, JJC-
dc.contributor.authorLiu, S-
dc.contributor.authorLi, KKW-
dc.date.accessioned2018-08-22T01:39:09Z-
dc.date.available2018-08-22T01:39:09Z-
dc.date.issued2018-
dc.identifier.citationInternational Ophthalmology, 2018, p. 1-8-
dc.identifier.issn0165-5701-
dc.identifier.urihttp://hdl.handle.net/10722/258482-
dc.description.abstractINTRODUCTION: An increasing number of patients are taking novel oral anticoagulant (NOAC) medication, making perioperative management in phacoemulsification surgery an important issue. This study reports the haemorrhagic complications of NOAC in phacoemulsification surgery. DESIGN: Retrospective case study over a 4-year period. METHODS: Consecutive cases receiving NOAC during the time of phacoemulsification were reviewed. Patients were either advised to continue medications (continued group) or withhold medications before surgery (withheld group). MAIN OUTCOME MEASURES: Details including patient demographics, preoperative assessment, postoperative outcome and intraoperative, postoperative and systemic complications were recorded. RESULTS: A total of 20,100 cases of phacoemulsification were performed. Of which, 66 cases were found to be on NOAC (0.33%). This included 66 eyes of 53 patients, with 42 continued and 24 withheld medications before surgery. There was no statistically significant difference between the two groups in demographics, cataract risk factors, baseline renal function, clotting profile, type of NOAC, incision size, phacoemulsification energy, preoperative and postoperative visual acuity. There was also no significant difference in intraoperative, postoperative and systemic complications (p = 1.00 and 0.53, Fischer's exact test). None of the patients in the continued group had postoperative complications; two cases in the withheld group receiving retrobulbar anaesthesia had bruising and subconjunctival haemorrhage after resumption of NOAC (p = 0.13, Fischer's exact test). CONCLUSION: The present study found no difference in haemorrhagic complications between cases continuing and withholding NOAC during phacoemulsification. Nevertheless, the potential risks and benefits to continue or withhold NOAC perioperatively should be carefully considered via a multidisciplinary approach.-
dc.languageeng-
dc.publisherSpringer Verlag Dordrecht. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=0165-5701-
dc.relation.ispartofInternational Ophthalmology-
dc.rightsThe final publication is available at Springer via http://dx.doi.org/[insert DOI]-
dc.subjectCataract-
dc.subjectHaemorrhagic complication-
dc.subjectNOAC-
dc.subjectNon-vitamin K antagonist oral anticoagulants-
dc.subjectNovel oral anticoagulant-
dc.subjectPerioperative-
dc.subjectPhacoemulsification-
dc.titlePhacoemulsification cataract surgery in patients receiving novel oral anticoagulant medications-
dc.typeArticle-
dc.identifier.emailCheung, JJC: janicejc@hku.hk-
dc.identifier.authorityCheung, JJC=rp02219-
dc.identifier.doi10.1007/s10792-018-0862-x-
dc.identifier.pmid29435797-
dc.identifier.scopuseid_2-s2.0-85041914815-
dc.identifier.hkuros287670-
dc.identifier.spage1-
dc.identifier.epage8-
dc.publisher.placeNetherlands-

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