Phacoemulification of Cataract in Patient Receiving Coumadin Therapy: Ocular and Hematologic Rik Aement Original Reearch Article

Purpoe To ae the rik of intra- and potoperative bleeding tendency aociated with uncomplicated cataract urgery by phacoemulification in patient receiving Coumadin treatment. Deign Propective, nonrandomized, interventional, conecutive cae erie. Method ixty-three conecutive patient underwent cataract extraction with len implantation in 75 eye. All patient were receiving Coumadin therapy at the time of urgery, and nine patient (14.3%) were alo taking antiaggregant. The operation were performed by phacoemulification technique under topical anetheia. All patient underwent a hemotatic work-up before intervention. tructured quetionnaire were completed by the urgeon immediately after the operation. In 18 (24%) eye, the urgery wa videotaped, and the tape were reviewed ubequently for any bleeding by an independent oberver. Reult Twelve patient (19%) underwent urgery in both eye, not imultaneouly. The mean prothrombin time international normalized ratio (INR) wa 2.03 at the time of the urgery. No ignificant intraoperative bleeding occurred. Four (6.3%) patient had minor potoperative ocular bleeding. A microcopic hyphema and a dot retinal hemorrhage were each een in one eye on the firt potoperative day, and mall iri hemorrhage were identified in two additional eye at the one-week viit. All bleeding diappeared within one week without affecting the viual acuity. The mean INR of the four patient with minor bleeding wa 2.1. Concluion Cataract urgery by phacoemulification in uncomplicated eye can be performed afely in patient receiving Coumadin treatment. However, a large clinical trial i required to ae the afety of continuou Coumadin treatment aociated with phacoemulification in eye with complicated cataract.