Perioperative assessment of anticoagulants. Anticoagulant usage is widespread and patients do not always volunteer the information that they are taking these drugs; thus, a thorough history is mandatory. These powerful agents significantly increase subconjunctival, anterior chamber, and suprachoroidal space bleeding associated with incisional glaucoma surgery. An increasingly common problem is the combined use of ASA and vitamin E; together these drugs severely inhibit platelet function preventing formation of the platelet plug. The following guidelines are useful to decrease bleeding associated with prophylactic antithrombotic drug therapy:
Plavix = clopidogrel, Ticlid = Ticlopidine, Aggrenox = ASA and dipyridamole, Coumadin = warfarin, Persantine = dipyridamole.