Are any precautions needed when performing cataract surgery in thrombocytopenic patients?
Reviewed by Mahmoud Ahmed

In this retrospective multi-centre study, charts for 196 eyes of 150 thrombocytopenic patients were reviewed. The mean preoperative platelet level was 73.0 ± 20.5 × 103/μL (median of 76.0 × 103/μL), with a range of 17 to 100 × 103/μL with a wide range of contributing systemic diseases. Surgeons involved included a mix of 122 residents and 74 attending. There were no complications from anaesthetic injections which included retrobulbar (n= 23), peribulbar (n= 6), and sub-Tenon (n=4). Iris haemorrhage occurred in two cases (1%), once at sulcus intraocular lens placement after the use of a Malyugin ring and the other during mechanical pupil stretching with Kuglin hooks. Both were easily controlled and resolved at the day one visit. There were no cases of hyphema or suprachoroidal haemorrhage. In this study, nine patients had platelet counts less than or equal to 30.0 × 103/μL who had uneventful surgeries. This large cohort of cases provides strong evidence that clear corneal cataract surgery is safe in patients with platelet counts of 17.0 to 100 × 103/μL without the need for preoperative testing or delaying surgery.

Thrombocytopenia and clear corneal incision cataract surgery.
Reilly GR, Tipton CW, Armbrust KR.
JOURNAL OF CATARACT AND REFRACTIVE SURGERY
2021;47(12):1556-60.