Antiplatelets and anticoagulants in glaucoma surgery and laser

Abstract:

With the increasing prevalence of cardiovascular diseases, it has become common for patients to be on different classes of anticoagulant medications. The blood-thinning characteristic of these drugs makes them essential for the management of long-term comorbidities, but it also raises the possibility of hemorrhagic complications during and after ophthalmic surgery. Although there is some agreement regarding the preoperative use of anticoagulant drugs in cataract surgery, little is known about the continuation or discontinuation of these drugs before surgeries for glaucoma. Regarding the use of anticoagulants before glaucoma surgery, surgeons’ practices differ greatly. Anticoagulation therapy must be understood in the context of glaucoma surgery and laser treatment, as the evidence currently available is inconclusive regarding the benefits of continuing/withholding anticoagulation or using bridging therapy. Modifying anticoagulation therapy for glaucoma surgery must be done carefully and after consulting primary care physicians, internists, cardiologists, and neurologists due to the potential serious adverse effects of stopping the treatment.