Father, 69, requires cataract surgery in both eyes. he's on dabigatran, clopidogrel for heart attack, atrial fibrillation, vascular stroke for 3 years. had minor strokes in 2008 and 2009. need advice on cataract surgery while on dabigatran, any risks?

Cataract surgery: while on anticoagulation therapy: this is a judgmental call amongst the ophthalmic surgeon and the anaesthesiologist. Generally for surgical procedures or spinal anesthesia, anticoagulaton needs to be discontinued before the surgery, as for Dabigatrean, 1-2 days prior to surgery and resumes after, while the clopidogrel needs to be withheld 5 days prior to surgery.Again refer to the treating team

Very little risk: Cataract surgery is considered a low-risk procedure for bleeding. It is. With the history of AF and recurrent strokes it would be strongly recommended that your Father continue his anticoagulants, but this needs to be discussed with his Opthalmologist. In a study of 750 patients on Warfarin type anticoagulants there were no ocular bleeding events in those who continued their anticoagulant.

Dr Hegab agreed

Talk to the Dr.: The ophthalmologist performing the procedure will give you instructions during your pre-op visit. He or she should tell you when to stop taking these medicines. They are normally discontinued several days before the planned procedure, but I would suggest that you discuss it with the surgeron. Also, talk to your Dad's cardiologist. They will be able to tell you the cardiac risks/beneftis

Dabigatran /cataract: Yes. dabigatran can cause more bleeding during surgery, which could affect the surgery .Many times they have patients in the hospital on heparin 1 day before the surgery and then stop the heparin 3-4 hours before surgery and restart meds after surgery This is an issue that has to be discussed with the cardiologist and surgeon especially since your father has had strokes f/u w/ cardiology