8 doctors weighed in:

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?

8 doctors weighed in
Dr. Al Hegab
Internal Medicine - Allergy & Immunology
5 doctors agree

In brief: 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 clopedogrel you to hold 5 days prior to elective surgery. Again refer to the treating team

In brief: 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 clopedogrel you to hold 5 days prior to elective surgery. Again refer to the treating team
Dr. Al Hegab
Dr. Al Hegab
Thank
2 comments
Dr. Louis Delcampo
ASRA Guidelines powered by Vanderbilt U. Hold Dabigatran (Pradaxa) 4 to 5 days prior to procedure and you may restart 24 hours after procedure However as Dr. AL Hegag has stated this is a professional judgement call between the Opthamologist performing the procedure and the Anesthesiologist providing the MAC / conscious sedation for this very common procedure
Dr. Al Hegab
Agree with Dr Delcampo
Dr. David Lipkin
Internal Medicine
1 doctor agrees

In brief: 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.

In brief: 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. David Lipkin
Dr. David Lipkin
Thank
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