Perioperative management of anticoagulants and antiplatelet agents in oculoplastic surgery.

PURPOSE OF REVIEW

The decision to stop or continue anticoagulants or antiplatelet therapy for oculoplastic procedures has long been a complicated and serious discussion for surgeons and their patients. Although other specialties have developed evidenced-based algorithms to guide their decision-making our subspecialty remains driven largely by anecdotal information. This article aims to get closer to an evidenced-based approach to perioperative anticoagulant and antiplatelet management.

RECENT FINDINGS

Over the last few years, new antiplatelet and anticoagulant therapies are on the market with different characteristics in terms of half-life and mechanism of action. It is imperative the contemporary surgeon be well versed in these new medications. Also, new studies have emerged from the vascular literature with specific evidenced-based recommendations for heart and stroke patients. These guidelines need to be weighed with a patient's cardiologist or neurologist.

SUMMARY

The article will review the old and new anticoagulant and antiplatelet therapies as well as the recent literature for stroke and cardiac patients to guide the oculoplastic surgeon in this nuanced decision. It will also discuss current practice patterns in light of these new therapies and medical guidelines.