Cataract Surgery while Anti-Coagulated ?

[ALCapshaw2]

I don't recall seeing the subject of Cataract Surgery on anti-coagulated patients being discussed before so I'm wondering, is that routinely performed while anti-coagulated or do the Eye Surgeons want their patients OFF Coumadin for the procedure?

 

[catwoman]

Al:

I think I have seen some post that they had had cataract surgery w/out having to go off warfarin. I took note of that, since I've had cataracts for about 10 years and will eventually need surgery.

Don't remember who it was who had posted about this. Have you done searched all the posts for "cataracts" to see what pops up?

 

[ALCapshaw2]

Good idea Marsha.

I found a few mentions of cataract plus this interesting thread
vereplacement.org/forums/showthread.php?28836-Warfarin-amp-Cataract-Surgery&highlight=cataract

It appears that most people do NOT go Off Coumadin for cataract surgery.

'AL'

 

[Ross]

I'm developing them now. Not looking forward to having them removed. Doc says we wait until it can no longer be corrected with glasses.

 

[Rich]

Al,
I had my cataract surgery a few years ago.
Anti-coagulation is not an issue, you do not have to stop Coumadin.
I will tell you it is one of the best things I have had done, my vision is now 20/20.
As a side note be aware there are a number of different lens out there(kind of like valves).
There are the traditional lens which most insurances including Medicare fully cover.
With these lens they can only fix your distance vision or your close-up vision, not both.
In my case I now must have reading glasses for close-up, it's no big deal and I buy really nice ones at the local dollar store for a buck a pair.
Then the other choice is bi-focal lens which can be implanted. These are not as good for distance vision but you never have to wear glasses again.
The down side is most insurances do not cover these lens and the cost is as much as $3000.00/eye.
Rich
PS;Al if I can offer any advice just let me know.

 

[Pat Hicks]

I had cataract surgery this spring. I did not have to go off anticoagulant or do anything special. Glad I had it done!

 

[ALCapshaw2]

Thanks for the inputs folks. More later.

 

[olefin]

I had a retina tear that required emergency (within 2 hours) laser surgery. No problem from being on warfarin. Same would go for cataract surgery.

 

[dick0236]

Good info. My eye doc told me two weeks ago that I will need this surgical procedure in a year or so.

 

[Ross]

Well at least for once, I'm not the crash test dummy!

 

[Mentu]

As part of my year of falling apart, I needed lens replacements for cataracts this past spring. There isn't any blood involved. There is a small incision on top of the eye through which the old yellowed and cloudy lens is removed and the crystal clear new one is inserted. There is no pain and it only takes about 20-30 minutes. You get lots of eye drops to use for awhile after you get home and usually are back at the Doctor's office the following morning for him to check your eye and remove the eye patch. You eye is really sensitive to light so they also give you dark, dark glasses to wear. Two or three days after surgery before you begin to see pretty well but it takes 6 months or so for your eyes to completely adjust. The real surprise is the shift in the colors you see. The old yellowed lens caused some blues to look green and reds to look dark. Suddenly, greens are very green and blue is where its supposed to be while reds seem a little weaker. You use drops for a month or so. The greatest pain for me was my inability to read easily because my Doctor didn't want to make new glasses until 6 weeks after the second eye was done (my eyes were done one month apart).

Larry

 

[ALCapshaw2]

Thanks for the step by step process description Larry !

'AL'

 

[Rich]

Al,
One very important thing I didn't mention nor anyone else.
This is critical for men facing cataract surgery.
If you are taking any alpha blockers for BPH (benign prostrate enlargement), It is CRITICAL that you inform your doctor of this.
These medications can cause what is known as floppy iris syndrome. They can constrict the pupil and not let it dialate properly which could lead to a failed surgery or worse.
Rich

 

[Gully Foyle]

I apologize for my bad English.
It is not necessary to stop the warfarin for cataract surgery only when using topical anesthesia (=eye drops).

 

[ALCapshaw2]

Al,
One very important thing I didn't mention nor anyone else.
This is critical for men facing cataract surgery.
If you are taking any alpha blockers for BPH (benign prostrate enlargement), It is CRITICAL that you inform your doctor of this.
These medications can cause what is known as floppy iris syndrome. They can constrict the pupil and not let it dialate properly which could lead to a failed surgery or worse.
Rich

Thanks Rich. Ross forwarded your PM to my e-mail address.
MY PM mailbox is hopelessly overloaded since the permitted allocation was reduced from 300 to 150 messages some time ago.

I tried to send an e-mail to you via VR but apparently you have opted Not to receive e-mails through the forum.

I wondered what "alpha blockers" were. Fortunately, I'm not taking any.

'AL'

 

[Ross]

I apologize for my bad English.
It is not necessary to stop the warfarin for cataract surgery only when using topical anesthesia (=eye drops).

Welcome to the forum Gully Foyle. Don't worry about your English, we can understand you.

I can't wait to see how you handle things in your country. Here in the U.S., our doctors for the most part, can't even grasp the basics of anticoagulation management. You'll hear me pounding on doctors, so don't take it personally. It's directed more so at those here that just will not get on the same page as those of you in Europe.

 

[Rich]

Hi Al,
I did e-mail you and of course you now have my address as well.
Anything I can advise you on, just let me know.
Rich

 

[Marty]

A few years ago I asked my opthamologist how he approached cataract surgery in a patient on warfarin. The wise-ass said "Very carefully"! His patients don't go off warfarin.

 

[ALCapshaw2]

Thanks Marty. Local group recommends INR <3.0 for Cataract Surgery.

'Simple' 1/4 inch incision on side of iris(?), break up cataract with ultrasound device,
push in rolled up (single vision) lens which unrolls once inside. Most patients do not require any stitches.
Covered by Insurance.

High Tech 'adjustable lens' $2000 per eye out of pocket.

I'll probably go with the single vision (adjusted for distance) and use reading / computer glasses for close up work, optimized for my distance requirements.

Haven't decided which guy to use yet.
My guy is youngster in the group. Very thorough and Nice Guy. Does 360/year.
High Volume guy does over 1300/year (I'm guessing production line style).
Is 360/year enough experience? or is additional skill learned with high volume?

 

[Ross]

Of course I'm watching in interest because I face cataract surgery some day down the road. Mine are getting pretty bad.