Anticoagulant and Antiplatelet Agents in Oculoplastic Surgery

Increasingly oculoplastic patients present for surgery taking a range of medications many of which influence haemostasis. A current knowledge of the properties of these medications and an informed risk assessment of the advisability or otherwise of stopping medication is required. Oculoplastic surgeons must be aware of the role of classic and new anticoagulants, antiplatelet agents and thrombolytic drugs, and know how to balance the risk of vision-threatening bleeding in the post-operative period if these drugs are continued, against the risk of a life-threatening event occurring if these medications are stopped. It is often necessary to involve the patient’s physician in what may be a very complex judgement. The details of each of these topics are discussed and options or alternatives described.