warfarin and Cataract

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Allopurinol; Anti-Bacterial Agents; Antimalarials; Cardiac Glycosides; Cataract; Child; Chloroquine; Chlorpromazine; Epinephrine; Ethambutol; Ethchlorvynol; Eye Diseases; Female; Humans; Miotics; Nalidixic Acid; Phosphates; Pilocarpine; Quinolines; Retinal Degeneration; Warfarin

Topics: Aged; Anticoagulants; Antihypertensive Agents; Bimatoprost; Cardiovascular Diseases; Cataract; Cataract Extraction; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Timolol; Trabeculectomy; Visual Acuity; Visual Field Tests; Visual Fields; Warfarin

Left ventricular assist devices (LVADs) have been increasingly used for 20 years in terminally ill patients with advanced heart failure or awaiting cardiac transplantation. Despite improvement in morbidity and mortality from use of these devices, quality of life may be limited by cataract. Access to cataract surgery in this predominantly elderly population is essential but limited by unfamiliarity with these devices. We describe phacoemulsification and intraocular lens implantation in 2 patients with LVADs. The patients had extensive preoperative cardiology evaluations and were instructed to continue warfarin through the day of surgery. Monitored sedation was used with fentanyl and midazolam. Both patients experienced significant improvement in visual acuity and quality of life. Neither experienced intraoperative hemodynamic instability. Cataract surgery may be safely performed in patients with LVAD support when adequate monitoring resources are available.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Activities of Daily Living; Aged; Anticoagulants; Cardiomyopathy, Dilated; Cataract; Heart Failure; Heart-Assist Devices; Humans; Lens Implantation, Intraocular; Male; Middle Aged; Phacoemulsification; Quality of Life; Warfarin

Two siblings were noted to have the physical stigmata of the fetal warfarin syndrome. Their mother had received warfarin sodium for thrombophlebitis during both pregnancies but not during that of an unaffected sibling. Teratogens may produce syndromes that mimic genetic disease in both phenotype and familial aggregation.

Topics: Abnormalities, Drug-Induced; Adult; Cataract; Child, Preschool; Chondrodysplasia Punctata; Female; Humans; Infant; Infant, Newborn; Male; Maternal-Fetal Exchange; Nose; Pregnancy; Pregnancy Complications, Cardiovascular; Teratogens; Thrombophlebitis; Warfarin