Thrombocytopenia and clear corneal incision cataract surgery

Purpose: To investigate complications and outcomes of dear corneal incision cataract surgery in patients with thrombocytopenia. Setting: 1 veterans hospital and 2 academic medical centers. Design: Multicenter retrospective chart review. Methods: All eyes of thrombocytopenic patients that underwent clear corneal incision cataract surgery with a platelet count of 100 x 10(3)/mu L or less measured within 30 days prior to surgery were included. Subject demographics, intraoperative complications, use of pupillary expansion devices, use of local anesthetic injections, and change in corrected distance visual acuity were recorded. Results: 3 sites recorded 40 113 dear corneal incision cataract surgeries, of which 196 eyes (0.49%) of 150 thrombocytopenic patients were recorded. The mean platelet count in the study subjects was 73.0 +/- 20.5 x 10(3)/mu L. Two cases of intraoperative iris hemorrhage that were readily and controlled occurred in conjunction with pupillary expansion. There were no bleeding complications associated with retrobulbar, peribulbar, or subTenon anesthetic injections. There was a statistically significant improvement (P < .0001) in visual acuity post-operatively. Conclusions: Clear corneal incision cataract surgery with pupillary expansion devices and local anesthetic injections can be safely performed in patients with thrombocytopenia. Copyright (C) 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS