Table 2.

Summary of online statements by United States ophthalmologic organizations discussing perioperative use of antithrombotic medications*

Organization	Statement type	Statement topic	Statement summary
AAO	Preferred practice pattern article16	Cataract surgery	Continuation of anticoagulants acceptable if INR therapeutic (I+ grade, good quality, strong recommendation) Discontinue aspirin perioperatively only if bleeding risk outweighs antiplatelet benefits (I− grade, good quality, strong recommendation) Management of patients on antithrombotics should be customized on a case-by-case basis
AAO	BCSC excerpt17	Cataract surgery	The ophthalmologist and primary care physician together should weigh systemic versus ocular surgical risks in deciding whether to interrupt or continue antithrombotics, and cases should be tailored on an individual basis Patients with atrial fibrillation or single DVT episode may be able to discontinue warfarin perioperatively; patients with prosthetic heart valve or recurrent DVT may require dose lowering rather than discontinuation Normal coagulation may require 3-5 days after stopping warfarin; restoration of platelet function requires at least 10 days after stopping antiplatelets Topical anesthesia or sub-tenon infusion, clear corneal incision, and IOL placement in the capsular bag may minimize hemorrhagic risk and forestall need to discontinue anticoagulants perioperatively Retrobulbar and peribulbar anesthetic injections increase risk of retrobulbar hemorrhage in these patients; the reverse trendelenburg position may lower this risk

*Statements include: Policies, guidelines, or educational articles or chapters directed toward ophthalmologists. INR: International normalized ratio, DVT: Deep vein thrombosis, AAO: American Academy of Ophthalmology, BCSC: Basic and Clinical Science Course, IOL: Intraocular lens