MANAGEMENT OF THE ANTICOAGULATED PATIENT FOR OPHTHALMIC SURGERY

The outcome of 50 surgical procedures in 41 patients who were anticoag ulated at the time of surgery were reviewed to determine whether antic oagulation was associated with an increase in ophthalmic morbidity. Tw enty-seven patients were receiving warfarin and 14 patients nicoumalon e. The International Normalised Ratio (INR) was determined immediately prior to surgery and ranged from 1.1 to 4.9. Thirty-nine operations w ere performed under local anaesthetic and 11 under general anaesthetic . Thirty-three patients had extracapsular cataract extractions with po sterior chamber lens implantation. No major haemorrhagic complications were associated with the local anaesthetic or the surgical procedure. Patients on anticoagulation therapy are at risk of life-threatening c omplications if their anticoagulation is stopped or reduced. This stud y demonstrates that most ophthalmic surgical procedures can be safely performed whilst the patient is therapeutically anticoagulated.