Phacoemulsification and lens implantation in patients treated with aspirin or warfarin

Purpose: To determine the incidence and nature of hemorrhagic complications in patients having phacoemulsification and foldable intraocular lens (IOL) implantation while taking aspirin or warfarin. Setting: The Jules Stein Eye Institute, University of California at Los Angeles School of Medicine, Los Angeles, California, USA. Methods: This retrospective study reviewed the charts from the practice of 1 ophthalmic surgeon. The type of medication, dosage, indication for anticoagulant therapy, type of incision, type of anesthesia, and intraoperative and postoperative hemorrhage complications were recorded. Results: Sixty-two patients (82 eyes) taking aspirin and 25 patients (31 eyes) taking warfarin were identified. Seven eyes in the aspirin group (8.5%) and 3 in the warfarin group (9.7%) experienced subconjunctival hemorrhages. Eight of the 10 subconjunctival hemorrhages occurred in eyes with scleral incisions. The remaining 2 occurred in eyes with corneal incisions. No eye developed lid ecchymosis, retrobulbar hemorrhage, hyphema, or suprachoroidal hemorrhage. Conclusions: Phacoemulsification with foldable IOL implantation was performed safely in patients taking aspirin or Warfarin. Subconjunctival hemorrhage was the most common hemorrhagic complication.