Eye Surgery While on Warfarin

[Guest]

Retina. 2007 Mar;27(3):290-5.
Anticoagulation with warfarin in vitreoretinal surgery.Fu AD, McDonald HR, Williams DF, Cantrill HL, Ryan EH Jr, Johnson RN, Ai E, Jumper JM.
Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California, USA. [email protected]

PURPOSE: To describe the clinical course of patients undergoing vitreoretinal procedures while receiving systemic anticoagulation with warfarin. METHODS: We reviewed patient demographics, ocular findings, and clinical courses for 25 patients receiving systemic anticoagulation with warfarin who subsequently underwent vitreoretinal surgery. RESULTS: Patient ages ranged from 49 years to 81 years (median, 69 years). Indications for anticoagulation included atrial fibrillation, cerebrovascular disease, deep vein thrombosis, prosthetic heart valves, and hypercoagulable state. Follow-up ranged from 4 months to 36 months (median, 19.5 months). The international normalized ratio ranged from 1.5 to 3.1 (median, 2.0). Final vision after surgery ranged from 20/20 to 20/400 (median, 20/100). One patient who underwent scleral buckling and external drainage of subretinal fluid had an intraoperative subretinal hemorrhage associated with the drainage procedure. In all other patients, no intraoperative complications occurred. CONCLUSION: Cessation of therapy with warfarin may not be necessary in patients receiving anticoagulation who are undergoing vitreoretinal procedures. Successful visual and anatomical results may be achieved after vitreoretinal surgery for patients receiving anticoagulation with warfarin. The management of anticoagulation should occur in conjunction with the patient's internist to allow a clear understanding of the potential systemic risks of cessation of warfarin treatment preoperatively.

AND STILL DENTISTS WANT TO STOP WARFARIN FOR A WEEK TO CLEAN YOUR TEETH.

 

[Ross]

It's not just them, as we all know, it's the majority of the medical community for any procedure. I simply cannot get over having someone like Dr. Ansell writing things that he did and the rest of the community is ignorant to these things.

 

[RobThatsMe]

Hi Al,

Just wanted to say.. "Great Post" !

I have been very curious about this, especially with more and more of us thinking about the possiblities of eye sight correct surgery these days.

Thank you for posting this.

Rob

 

[Guest]

Retinal surgery has a much greater risk of bleeding that does vision correction surgery, so this is really an important report.

 

[Sierra Bob]

I had a Baerveldt implant in my right eye for glaucoma last year as a result of treatment for a Central Artery Retinal Occusion. I was on warfarin with an INR 3.6 (target 3.5). I had some minor bleeding but no serious problems. You can "Google" Baerveldt Implant and take a look at it.

 

[Guest]

Today there was another report almost the same as this that also found that warfarin often did not need to be stopped to do eye surgery.

 

[Marty]

I asked my opthamologist how he would handle my cataract surgery with out stopping warfarin. He said " very carefully".

 

[Blanche]

Albert had cataract surgery on both eyes (one at a time) while on Coumadin. When I asked his opthamologist how many cataract surgeries he has done, he replied more than 15,000. In his entire career, he has NEVER taken a patient off Coumadin for cataract surgery.
Regards,
Blanche