Key result
Continuing, withholding, or bridging anticoagulation before glaucoma surgery shows inconclusive benefits for preventing complications.
Why the study?
Little is known about continuing or discontinuing anticoagulants before glaucoma surgeries, and surgeons' practices differ greatly because current evidence is inconclusive.
How should antiplatelet and anticoagulant medications be managed to prevent hemorrhagic complications in patients undergoing glaucoma surgery?
How should antiplatelet and anticoagulant medications be managed to prevent hemorrhagic complications in patients undergoing glaucoma surgery?
Management of anticoagulation before glaucoma surgery lacks conclusive evidence and requires individualized multidisciplinary decision-making to balance bleeding and thrombotic risks.
Management of anticoagulants around ophthalmic surgery remains uncertain; leaves open need for higher-level evidence to guide decisions.
With the increasing prevalence of cardiovascular diseases, it has become common for patients to be on different classes of anticoagulant medications. The blood-thinning characteristic of these drugs makes them essential for the management of long-term comorbidities, but it also raises the possibility of hemorrhagic complications during and after ophthalmic surgery. Although there is some agreement regarding the preoperative use of anticoagulant drugs in cataract surgery, little is known about the continuation or discontinuation of these drugs before surgeries for glaucoma. Regarding the use of anticoagulants before glaucoma surgery, surgeons’ practices differ greatly. Anticoagulation therapy must be understood in the context of glaucoma surgery and laser treatment, as the evidence currently available is inconclusive regarding the benefits of continuing/withholding anticoagulation or using bridging therapy. Modifying anticoagulation therapy for glaucoma surgery must be done carefully and after consulting primary care physicians, internists, cardiologists, and neurologists due to the potential serious adverse effects of stopping the treatment.
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Udenia et al. (2026) conducted a review in Glaucoma. Anticoagulation therapy was evaluated. Current evidence is inconclusive regarding the benefits of continuing, withholding, or using bridging therapy for anticoagulation before glaucoma surgery and laser treatment.
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