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Combined aspirin and clopidogrel therapy in phacoemulsification cataract surgery: a risk factor for ocular hemorrhage?

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Abstract

Purpose

To evaluate the safety of phacoemulsification cataract surgery in the patients undergoing dual antiplatelet therapy with aspirin and clopidogrel.

Methods

Consecutive patients undergoing phacoemulsification cataract surgery with a clear corneal incision under topical anesthesia were eligible for inclusion in the study. Thirty-eight eyes from 38 patients on combined aspirin and clopidogrel therapy who continued the treatment were classified into the maintenance group, a matched group of 38 eyes from 38 patients on no antiplatelet/anticoagulant therapy as the control group. The best-corrected visual acuity (BCVA) and incidences of complications were compared between the two groups.

Results

There was no significant difference in final BCVA between the maintenance group and the control group (p = 0.178). No significant difference existed in the incidences of hemorrhagic or non-hemorrhagic complications between the two groups (p = 0.529 and p = 0.589, respectively). Moreover, no surgery was postponed or cancelled due to hemorrhagic complications in either group, and no cardiovascular events occurred during the follow-up. There was no case of anterior chamber hemorrhage, vitreous hemorrhage, or suprachoroidal hemorrhage.

Conclusions

Our outcomes indicated that phacoemulsification cataract surgery using a clear corneal incision with topical anesthesia could be safely done without stopping dual antiplatelet therapy with aspirin and clopidogrel.

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Funding

This study was funded by grants from the National Natural Science Foundation of China (No. 81670868 and 81900879).

Author information

Author notes

  1. Qingjian Li and Xuzhong Shen have contributed equally to this work.

  2. Zhiliang Wang and Pei Zhang have contributed equally to this work.

Authors and Affiliations

  1. Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China

    Qingjian Li, Shaopan Wang, Ting Su & Ke Yan

  2. Department of Ophthalmology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China

    Qingjian Li, Xuzhong Shen, Yu Zhang, Yiwen Qian, Jing Jiang & Zhiliang Wang

  3. Department of Ophthalmology, Shanghai Gonghui Hospital, No. 6, Lane 315, Shimen Road (No. 1), Shanghai, 200040, China

    Pei Zhang

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  1. Qingjian Li
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Correspondence to Pei Zhang or Zhiliang Wang.

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No author has a financial or proprietary interest in any material or method mentioned.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of Huashan Hospital affiliated to Fudan University and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, Q., Shen, X., Wang, S. et al. Combined aspirin and clopidogrel therapy in phacoemulsification cataract surgery: a risk factor for ocular hemorrhage?. Int Ophthalmol 40, 2023–2029 (2020). https://doi.org/10.1007/s10792-020-01378-5

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  • DOI: https://doi.org/10.1007/s10792-020-01378-5

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