Is It Really Safe to Discontinue Anticoagulant/antiplatelet Treatment Before Ptosis Surgery From Serious Bleeding?
Abstract PurposeTo evaluate the effects of discontinuing anticoagulants(ACs)/antiplatelets(APs) preoperatively on surgery for blepharoptosisMethodA retrospective analysis included patients with acquired blepharoptosis who underwent surgical correction, and were followed for more than one month. Patients were classified into two groups depending on AC/AP treatment or otherwise. All patients taking AC/AP discontinued with the treatment one week prior to surgery in accordance with our clinical guidelines. Preoperative and postoperative marginal reflex distance 1(MRD1) and ecchymosis grade were evaluated and compared.ResultsGroup 1 (AC/AP treatment cessation) included 47 patients with 93 eyelids, and group 2 (control) included 51 patients with 98 eyelids. The preoperative MRD1 showed no significant difference between groups. Group 1 showed a significantly higher rate of severe ecchymosis (41.8 vs. 22.4%, p = 0.004) at 1 week of surgery as well as 'persistent ecchymosis (58.8 vs. 7.3%, p=0.000) compared with group 2 postoperatively at 1 month. Postoperative MRD1 was significantly lower in group 1 at 1 week (p=0.019). However, the MRD1 and degree of improvement in lid height (postoperative MRD1–preoperative MRD1) was not significantly different between the two groups (p = 0.499, p = 0.058) at 1 month postoperatively.ConclusionPostoperative ecchymosis was more severe in group 1 at one month after ptosis surgery even though the ACs/APs were discontinued. Surgeons should be careful about this before operation.