Peroperative Haemorrhagic Complications of Ocular Surgery With Concomitant Use of Aspirin Therapy

Abstract

Abstract: : Purpose: The use of aspirin is widespread in the general population and although this may be on a prescription basis, it often takes the form of self-medication without direct medical supervision. Patients taking aspirin and other anticoagulants pose a special challenge when planning ocular surgery since the benefits of continuation of the medication must be weighed against the increased risk of ocular haemorrhagic complications. With no consensus in the literature regarding continuation or cessation of aspirin use, we have described a series of patients who developed acute suprachoroidal haemorrhage secondary to the use of aspirin, with the aim of providing evidence upon which to base a rational policy for perioperative use of this medication. Methods: A retrospective case note review was made of patients over an eighteen-month period that were under the care of two consultant ophthalmologists. The patients described in the case series were identified from a log of serious haemorrhagic complications from theatre records. Results: Our review identified five cases of suprachoroidal haemorrhage over the eighteen-month period with all having the common risk factor of the preoperative use of aspirin. Conclusion: We concluded that the use of aspirin is a risk factor for the development of acute suprachoroidal haemorrhage, one of the most serious complications of ocular surgery. This case series highlights the need for consideration of all potential risk factors, such as aspirin use, prior to ocular surgery and the need for appropriate protocol development. We recommend that aspirin should be stopped in cases of self-medication without underlying systemic disease, and in more complex cases the advice of a physician should be sought.

Keywords: 582 small incision cataract surgery