The effect of aspirin and warfarin therapy in trabeculectomy

C. J. Cobb, S. Chakrabarti, V. Chadha, R. Sanders

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    47 Citations (Scopus)

    Abstract

    Aim
    The management of patients on antiplatelet and anticoagulation therapy (APACT) in glaucoma surgery currently has no specific recommendations. We aimed to establish the risk of haemorrhagic complications and surgical outcome in patients on APACT in glaucoma surgery.

    Methods
    We retrospectively examined 367 consecutive trabeculectomies performed between 1994 and 1998. Preoperatively 60 (16.4%) patients were on APACT (55 on aspirin and five on warfarin). The incidence of hyphaema and haemorrhagic complications between patients with and without APACT was documented. Surgical success was defined in two categories as an intraocular pressure (IOP) <21 mmHg and an IOP <16 mmHg 2 years following trabeculectomy with and without antiglaucoma medication.

    Results
    None of the patients on aspirin suffered significant intra or postoperative haemorrhage. Aspirin was associated with a significantly higher risk of hyphaema (P=0.0015) but this was not found to significantly affect IOP control at 2 years. Patients on warfarin suffered haemorrhagic complications and trabeculectomy failure.

    Conclusions
    Aspirin appears to be safe to continue with during trabeculectomy. Patients on aspirin have an increased risk of hyphaema following trabeculectomy. This however does not appear to affect surgical outcome. Warfarinised patients are at risk of serious bleeding complications. They require careful monitoring pre- and postoperatively and are at risk of trabeculectomy failure.
    Original languageEnglish
    Pages (from-to)598-603
    Number of pages6
    JournalEye
    Volume21
    Issue number5
    DOIs
    Publication statusPublished - 2007

    Keywords

    • Adolescent
    • Adult
    • Aged
    • Aged, 80 and over
    • Anticoagulants
    • Antihypertensive Agents
    • Aspirin
    • Blood Loss, Surgical
    • Child
    • Drug Administration Schedule
    • Epidemiologic Methods
    • Eye Hemorrhage
    • Glaucoma
    • Humans
    • Hyphema
    • Intraocular Pressure
    • Middle Aged
    • Platelet Aggregation Inhibitors
    • Postoperative Hemorrhage
    • Trabeculectomy
    • Treatment Outcome
    • Warfarin

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