Management of patients with chronic hepatitis and cirrhosis during the periooperative period of ophthalmic surgery

Abstract

Aim. To study the frequency and structure of hepatitis and cirrhosis among ophthalmic surgery patients.Material and methods. Among 1706 ophthalmic surgery patients, 43 patients with chronic hepatitis and cirrhosis were selected. A clinical assessment of the etiology and severity of their condition was carried out and the possibility of performing ophthalmic surgery was determined.Results. The average age of the patients included in the study comprised 64.1 ± 9.7 years, with 72.1% of the patients belonging to the elderly age group. 88.4%, 9.3%, and 2.3% (one patient) of the patients suffered from viral hepatitis (B, C, chronic HBV and HCV coinfection), toxic hepatitis, and autoimmune hepatitis, respectively. Among hepatitis patients, HCV monoinfection prevailed (55.4%). The majority (97.7%) of patients demonstrated minimal disease activity. Although violations of the hemostatic system were detected in nine patients, signs of significant hypocoagulability were observed in three patients (6.9%). Following a 3-day course of intramuscular vitamin K injections 2 to 3 times per day, these three patients underwent successful ophthalmic surgery. Out of 97.7% of patients admitted to surgery, 39 people were operated in a planned manner and 3 people required medical preparation. In one patient with suspected acute viral hepatitis B, planned surgical treatment was postponed.Conclusions. The share of patients with hepatitis and cirrhosis in the general structure of ophthalmic surgery patients comprised 2.5%. Among them, viral hepatitis B and C prevailed (88.4%) with dominated HCV monoinfection (55.4%). The vast majority of patients (97.7%) showed minimal hepatitis activity; 6.9% had signs of significant hypocoagulability, thus requiring preoperative medical preparation.