Summary
Objective. We aim to review the literature regarding the risks of haemorrhage-related complications and the management of antithrombotic drugs during peri-operative period of various eye surgeries.
Methods. Review and analysis of the scientific literature was performed using ‘PubMed’and ‘Medline’ databases. The guidelines and recommendations of the American Academy of Ophthalmology, British Royal College of Ophthalmologists and the European Society of Cardiology were used.
Results and conclusions. The number of patients with cardiovascular diseases on antiplatelet and/or anticoagulants is increasing with the aging population. Age-related ophthalmic diseases requiring surgery are also becoming more common in ophthalmologists’ practice. While planning cataract, glaucoma or any other eye surgery, it is important to assess patient’s medications and their possible effect on the success of the surgery. There is a lack of consensus among the eye surgeons regarding the approach on managing antiplatelet and anticoagulant therapy before ophthalmic surgery. It is common practice to temporarily discontinue antithrombotic treatment before some ophthalmic interventions. This reduces the risk of haemorrhage and haemorrhage-associated visual impairment. However, discontinuation of antithrombotic medication can lead to life-threatening thromboembolic events. To minimize the risk of both, haemorrhagic and thromboembolic, complications, eye surgeons should be aware of the bleeding risk and specifics of antiplatelet and anticoagulant drugs administration. Discontinuation of antithrombotic drugs is not recommended during routine cataract surgery. The risk of haemorrhage and thromboembolic events should be assessed individually for other ophthalmic surgeries. For complex cases multi-disciplinary approach should be pursued.
