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Thrombocytopenia and Clear Corneal Incision Cataract Surgery

J Cataract Refract Surg. 2021 Apr 22. doi: 10.1097/j.jcrs.0000000000000676. Online ahead of print.

ABSTRACT

PURPOSE-: To investigate complications and outcomes of clear corneal incision cataract surgery in patients with thrombocytopenia.

SETTING-: One veterans hospital and two academic medical centers DESIGN-: Multi-center retrospective chart review.

METHODS-: All eyes of thrombocytopenic patients that underwent clear corneal incision cataract surgery with a platelet count ≤100 x 10/µl measured ≤30 days prior to surgery were included. Subject demographics, intraoperative complications, use of pupil expansion devices, use of local anesthetic injections, and change in best corrected visual acuity were recorded.

RESULTS-: Three sites recorded 40,113 clear corneal incision cataract surgeries, of which 0.49% (196 eyes) were performed on 150 thrombocytopenic patients. The mean platelet count in the study subjects was 73.0×10/µl ± 20.5×10/µl. Two cases of intraoperative iris hemorrhage which were readily controlled occurred in conjunction with pupillary expansion. There were no bleeding complications associated with retrobulbar, peribulbar, or sub-Tenon anesthetic injections. There was a statistically significant improvement (p <0.0001) in visual acuity postoperatively.

CONCLUSION-: Clear corneal incision cataract surgery with pupillary expansion devices and local anesthetic injections can be safely performed in patients with thrombocytopenia.

PMID:33929795 | DOI:10.1097/j.jcrs.0000000000000676

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