The literature recommendations that all anti-thrombotic agents be continued for routine cataract surgeries that were performed under topical or sub-Tenon’s anesthesia.
For sharp-needle anesthesia, the literature recommended that surgeons avoid dual antiplatelet therapy and patients could continue taking warfarin if the International Normalized Ratio (INR) was within the therapeutic range.
For glaucoma surgery, the literature recommended that aspirin and clopidogrel be discontinued when the drugs are monotherapy for primary prevention, but they can be continued for secondary prevention of cardiovascular diseases. P2Y12 receptor inhibitors should be discontinued if used as dual antiplatelet therapy.
However, the risks and benefits of continuation of antiplatelet agents need special consideration in neovascular glaucoma and high IOP.
The investigators emphasized, “It is also important to consider and recognise that, intraoperative and post-operative haemorrhagic complications in glaucoma, especially if sustained or prolonged, can cause severe visual loss due to high pressure in already compromised optic nerves. Anticoagulants should be discontinued with consideration for bridging therapy depending on patient’s risk factors.”