Subscribe to RSS
DOI: 10.1055/a-2315-2206
Perioperative Management of Coagulation Disorders in Ophthalmic Surgery
Article in several languages: deutsch | EnglishAbstract
Disorders of blood coagulation can lead to manifest spontaneous bleeding and an increased risk of bleeding during surgical procedures and interventions. Pathophysiologically, a distinction can be made between defects in primary haemostasis, which lead to impaired platelet adhesion and platelet aggregation, and disorders of secondary (plasmatic) haemostasis, which are characterised by impaired fibrin formation or fibrin stabilisation. Aetiologically, a distinction can be made between rare genetically-determined hereditary defects and common acquired coagulation disorders, which may be based on different pathomechanisms. This overview is intended to provide ophthalmic surgeons with a basis for the perioperative management of patients with genetically determined coagulation disorders undergoing ophthalmic surgery. As there are no specific recommendations in this regard, the recommendations are based on the procedure for other surgical interventions, taking into account the specific bleeding risk associated with ophthalmic surgery.
Publication History
Received: 10 March 2024
Accepted: 23 April 2024
Article published online:
15 August 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References/Literatur
- 1 Feltgen N, Mele B, Dietlein T. et al. Umgang mit gerinnungshemmenden Substanzen in der Ophthalmochirurgie – eine Umfrage unter Ophthalmochirurgen in Deutschland. Ophthalmologe 2018; 115: 585-591
- 2 Sucker C, Hager A, Koscielny J. et al. Orale Antikoagulation: Aktuelle Übersicht und perioperatives Management in der Ophthalmochirurgie. Ophthalmologe 2019; 116: 144-151
- 3 Zeitz O, Wernecke L, Feltgen N. et al. Antikoagulation und Thrombozytenfunktionshemmung: Was in der augenärztlichen Praxis zu beachten ist. Ophthalmologe 2021; 118: 1287-1300
- 4 Lauermann P, Klingelhöfer A, Mielke D. et al. Risk Factors for Severe Bleeding Complications in Vitreoretinal Surgery and the Role of Antiplatelet or Anticoagulant Agents. Ophthalmol Retina 2021; 5: e23-e29
- 5 Lauermann P, Klingelhöfer A, Mielke D. et al. Risk Factors for Severe Bleeding Complications in Glaucoma Surgery and the Role of Antiplatelet or Anticoagulant Agents. Clin Ophthalmol 2022; 16: 1245-1254
- 6 Sucker C. Grundlagen der Blutgerinnung. In: Sucker C, Pfitzmann R. Hrsg. Klinische Hämostaseologie in der Chirurgie. Berlin, Boston: De Gruyter; 2017
- 7 Monroe DM, Hoffman M. What does it take to make the perfect clot?. Arterioscler Thromb Vasc Biol 2006; 26: 41-48
- 8 Alberio L. My patient is thrombocytopenic! Is (s)he? Why? And what shall I do? A practical approach to thrombocytopenia. Hamostaseologie 2013; 33: 83-94
- 9 Swain F, Bird R. How I approach new onset thrombocytopenia. Platelets 2020; 31: 285-290
- 10 Mititelu A, Onisâi MC, Roşca A. et al. Current Understanding of Immune Thrombocytopenia: A Review of Pathogenesis and Treatment Options. Int J Mol Sci 2024; 25: 2163
- 11 Bundesärztekammer. Querschnitts-Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten. Gesamtnovelle 2020. Im Internet (Stand: 03.06.2024): https://www.bundesaerztekammer.de/fileadmin/user_upload/_old-files/downloads/pdf-Ordner/MuE/Querschnitts-Leitlinien_BAEK_zur_Therapie_mit_Blutkomponenten_und_Plasmaderivaten-Gesamtnovelle_2020.pdf
- 12 Pecci A, Balduini CL. Inherited thrombocytopenias: an updated guide for clinicians. Blood Rev 2021; 48: 100784
- 13 Scharf RE. Erworbene Plättchenfunktionsstörungen: Pathogenese, Klassifikation, Häufigkeit, Diagnostik und Behandlung. Hamostaseologie 2008; 28: 299-311
- 14 Gresele P, Bury L, Mezzasoma AM. et al. Platelet function assays in diagnosis: an update. Expert Rev Hematol 2019; 12: 29-46
- 15 Sharma R, Flood VH. Advances in the diagnosis and treatment of Von Willebrand disease. Blood 2017; 130: 2386-2391
- 16 Weyand AC, Flood VH. Von Willebrand Disease: Current Status of Diagnosis and Management. Hematol Oncol Clin North Am 2021; 35: 1085-1101
- 17 Castaman G. How I treat von Willebrand disease. Thromb Res 2020; 196: 618-625
- 18 Sucker C, Michiels JJ, Zotz RB. Causes, etiology and diagnosis of acquired von Willebrand disease: a prospective diagnostic workup to establish the most effective therapeutic strategies. Acta Haematol 2009; 121: 177-182
- 19 Sucker C. Angeborene und erworbene Gerinnungsdefekte. In: Sucker C, Pfitzmann R. Hrsg. Klinische Hämostaseologie in der Chirurgie. Berlin, Boston: De Gruyter; 2017