warfarin and Eyelid-Diseases

Patients undergoing intraocular surgery are elderly and may have disease or be receiving medication which increases the risk of haemorrhage. We interviewed 1383 consecutive patients scheduled for eye surgery requiring retrobulbar/peribulbar block about their use of non-steroidal anti-inflammatory drugs, oral steroids and warfarin. A history of diabetes mellitus and globe axial length was noted. Medial peribulbar and inferolateral retrobulbar blocks were performed by three specialists and six doctors in training. The ensuing haemorrhages were graded as follows: 1 = spot ecchymosis; 2 = lid ecchymosis involving half of the lid surface area or less; 3 = lid ecchymosis all around the eye, no increase in intraocular pressure; 4 = retrobulbar haemorrhage with increased intraocular pressure. Acetylsalicylic acid was taken by 482 (35%) patients, non-steroidal anti-inflammatory drugs by 260 (19%) and warfarin by 76 (5.5%). Lid haemorrhages (grades 1-3) were observed in 55 patients (4.0%); in 33 of these patients the haemorrhages were spotlike (grade 1). No grade 4 haemorrhages occurred. The preoperative use of acetylsalicylic acid, non-steroidal anti-inflammatory drugs or warfarin, whether or not they had been discontinued, did not predispose to haemorrhage associated with retrobulbar/peribulbar block.

Topics: Adult; Aged; Aged, 80 and over; Anesthesia, Local; Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Aspirin; Eye Hemorrhage; Eyelid Diseases; Female; Humans; Male; Middle Aged; Ophthalmologic Surgical Procedures; Prospective Studies; Retrobulbar Hemorrhage; Risk Factors; Warfarin

Topics: Aged, 80 and over; Anticoagulants; Drug Eruptions; Eyelid Diseases; Female; Heart Valve Prosthesis Implantation; Humans; Necrosis; Skin; Warfarin

To evaluate complications resulting from increased bleeding, 2,178 cataract surgery patients, 28 of whom were on anticoagulants, were studied prospectively. The anticoagulated patients showed no increase in sight-threatening complications when compared to the nonanticoagulated cataract patients.

Topics: Aged; Anticoagulants; Cataract Extraction; Conjunctival Diseases; Ecchymosis; Eyelid Diseases; Hemorrhage; Heparin; Humans; Hyphema; Middle Aged; Prospective Studies; Visual Acuity; Warfarin