Buscar en
Archivos de la Sociedad Española de Oftalmología (English Edition)
Toda la web
Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Update on the perioperative management of antiplatelets and anticoagulants in op...
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
0
Review
Available online 5 March 2021
Update on the perioperative management of antiplatelets and anticoagulants in ophthalmic surgery
Actualización en el manejo perioperatorio de antiagregantes y anticoagulantes en cirugía oftalmológica
Visits
...
J.C. Herranz-Heras
Corresponding author
jc.herranzh@gmail.com

Corresponding author.
, L. Alcalde-Blanco, I. Cañas-Zamarra, E. Mencía-Gutiérrez, M. Ferro-Osuna, S. Pérez-Trigo
Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
Received 12 May 2020. Accepted 06 November 2020
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (7)
Table 1. CHA2DS2-VASc scale for the assessment of thromboembolic risk in patients with atrial fibrillation.
Table 2. Summary of the main indications of anticoagulant drugs and stratification of thromboembolic risk.
Table 3. Stratification of thromboembolic risk in patients with a diagnosis of cerebrovascular disease or peripheral arterial disease according to the time of evolution since diagnosis.
Table 4. Stratification of thromboembolic risk in patients diagnosed with acute coronary syndrome according to time of evolution since diagnosis and treatment received.
Table 5. Stratification of thromboembolic risk in patients with diagnosis of stable coronary disease according to the time of evolution since diagnosis and the treatment received.
Table 6. Summary of recommendations on perioperative management of antiaggregant drugs in ophthalmic surgery.
Table 7. Summary of recommendations on perioperative management of anticoagulant drugs in ophthalmic surgery.
Show moreShow less
Abstract
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.

Keywords:
Anticoagulation
Antiplatelet
Perioperative
Ophthalmic surgery
Resumen
Introducción

Los fármacos anticoagulantes y antiagregantes son ampliamente utilizados con indicaciones médicas diversas. Por tanto, hay cada vez más pacientes que precisan una cirugía oftalmológica programada y se encuentran en tratamiento con esta mediación. El conocimiento acerca de sus implicaciones y su correcto abordaje perioperatorio permite reducir complicaciones quirúrgicas y efectos adversos en los pacientes. En muchas ocasiones no hay una recomendación clara sobre cómo actuar con estas familias de fármacos en determinadas cirugías.

Objetivo

Realizar una revisión bibliográfica sobre el manejo perioperatorio de los antiagregantes y anticoagulantes en cirugía oftalmológica.

Material y métodos

Se revisan los protocolos y la literatura existente acerca del empleo de dichos fármacos en diversas cirugías oftálmicas, incluyendo catarata, vítreo-retina, glaucoma, cirugía oculoplástica y orbitaria y estrabismo.

Resultados

Se referencian guías clínicas y estudios realizados que recogen las recomendaciones acerca del mantenimiento o suspensión de antiagregantes y anticoagulantes en diferentes campos quirúrgicos de la oftalmología.

Conclusiones

En la cirugía de catarata mediante facoemulsificación con anestesia tópica existe evidencia de que el mantenimiento de la medicación antitrombótica es seguro. En el resto de cirugías oftalmológicas se debería actuar en función del riesgo hemorrágico y trombótico que presente la cirugía y el paciente para una correcta utilización de los mismos. En casos complejos, se recomienda un abordaje multidisciplinar. Serían necesarios más estudios para la confección de guías clínicas que faciliten el manejo perioperatorio de estos fármacos en cirugía oftalmológica.

Palabras clave:
Anticoagulación
Antiagregación
Perioperatorio
Cirugía oftalmológica

Article

These are the options to access the full texts of the publication Archivos de la Sociedad Española de Oftalmología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Archivos de la Sociedad Española de Oftalmología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos