ABSTRACT
PURPOSE: To study the association between chronic intake of aspirin and intraoperative bleeding during cataract surgery and the effect of discontinuing the medication before surgery. SETTING: Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. METHODS: Sixty-one patients having cataract surgery and receiving aspirin to prevent thromboembolic events were divided into 3 groups: Group A, continuation of the medication; Group B, cessation of aspirin intake for 2 to 5 days before surgery; Group C, cessation of medication for 7 to 10 days before surgery. Blood tests of coagulation parameters, a detailed questionnaire, and 1 day and 1 week follow-up were evaluated. RESULTS: There were no significant differences in blood tests and the amount and incidence of intraoperative bleeding among the 3 groups. Diathermy was used somewhat more in Group A; however, there was no difficulty stopping the bleeding in any case and discontinuation of the medication had no effect on the intraoperative course or postoperative outcome. CONCLUSIONS: Aspirin intake was not associated with significant intraoperative bleeding; thus, discontinuation of aspirin is usually not indicated. Clear corneal phacoemulsification is advantageous in patients receiving antiplatelet therapy.
Subject(s)
Aspirin/administration & dosage , Blood Loss, Surgical , Cataract Extraction , Fibrinolytic Agents/administration & dosage , Aspirin/adverse effects , Eye Hemorrhage/chemically induced , Eye Hemorrhage/epidemiology , Fibrinolytic Agents/adverse effects , Follow-Up Studies , Hematocrit , Hemoglobins/analysis , Humans , Incidence , Lens Implantation, Intraocular , Partial Thromboplastin Time , Prospective Studies , Prothrombin Time , Surveys and QuestionnairesABSTRACT
Six observers (three physicians and three nurses) assessed 27 wounds of different types in 20 elderly patients, using five different classification systems. Using classification by colours, inter-observer agreement was moderate when six colours were used (70% agreement, group kappa 53%), and good if this was reduced to three (80% agreement, group kappa 64%). Results were only moderate using the Shea scoring system (68% agreement, group kappa 42%). Assessment for signs of infection was fair to moderate (75-85% agreement, group kappa 29-55%), but there was high inter-observer agreement for size and area (analysis of variance, p > or = 0.88).
