Perioperative management of cataract surgery in patients with severe systemic diseases

Abstract

Objective To evaluate the efficacy of perioperative management in cataract patients with severe systemic diseases. Methods Data of 55 eyes of 40 cataract patients with severe systemic diseases in Bazhou Area of Xinjiang were collected and retrospectively analyzed. They underwent cataract surgery. The preoperative managements included discontinuing anticoagulant drugs 7 days preoperatively in patients with coronary artery stent implantation and cerebral infarction. If there was no bleeding 3 days postoperatively, the anticoagulant drugs were restarted.No Heparin used during renal dialysis in patients with renal insufficiency from 1 day before surgery to 7 days after surgery. If there was no bleeding 7 days postoperatively, the Heparin dialysis was restarted. Patients with idiopathic thrombocytopenic purpura accepted blood transfusion preoperatively, which made platelets reaching more than 50×109/L. Patients with leukemia in plateau were kept in a stable phase after systemic treatment preoperatively. The surgical options included phacoemulsification in 52 eyes of 38 patients and extracapsular cataract extraction in 3 eyes of 2 patients. Posterior chamber intraocular lens were implanted in capsular bag of all patients.The follow-up time was 2-4 months. Results Three days postoperatively, cornea edema occurred in 6 eyes, anterior chamber exudates in 3 eyes, and temporary elevation of intraocular pressure in 1 eye respectively. One week postoperatively, severe anterior chamber exudates in 2 eyes, viral keratitis in 1 eye. No obvious progression of systemic disease observed during follow-up period. The visual accuity was improved after surgery. Conclusion Systemic diseases are positive controlled, they can undergo cataract surgery successfully and gain better prognosis. Key words: Cataract; Perioperative period; Systemic diseases, severe