AMBULATORY EYE SURGERY AND ANTITHROMBOTIC THERAPY--NEW APPROACHES/JEDNODNEVNA OCNA KIRURGIJA I ANTIKOAGULANTNA TERAPIJA - NOVIJI PRISTUPI

One of the most common surgeries in elderly patients is eye surgery. An increasing number of patients undergoing ambulatory eye surgery are on antithrombotic therapy. These drugs may increase the risk of perioperative bleeding associated with ophthalmic needle blocks and/or eye surgery. Intraoperative bleeding and postoperative hemorrhagic complications may lead to the loss of vision or even eyes. On the other hand, stopping anticoagulants and antiplatelets before the surgery may increase the risk of thrombotic events with potentially life-threatening complications. The aim of this narrative review is to provide a systematic review of the published evidence for the perioperative antithrombotic management of patients undergoing different types of eye surgery in ambulatory settings. A comprehensive review of the English-language medical literature search utilizing PubMed, Ovid Medline[R] and Google Scholar from January 2015 to December 2018 was performed. The database searches included studies providing evidence relevant to ambulatory eye surgery and perioperative antiplatelet medications and anticoagulants. Updated recommendations will be given for continuation, discontinuation, and modification of antithrombotic agents in order to optimize the management of antithrombotic therapies in outpatients scheduled for eye surgery. Key words: Surgical procedure, ophthalmologic; Ambulatory surgery; Anesthesia, regional; Anticoagulants; Agents, antiplatelet U populaciji bolesnika starije dobi ocni kirurski zahvati su jedni od najcescih kirurskih zahvata. Sve vise bolesnika kojima je potreban kirurski zahvat na ocima su starije dobi i vecinom su na kronicnoj terapiji lijekovima ukljucujuci antitrombocitne lijekove. Ti lijekovi mogu povecati rizik od perioperacijskog krvarenja prilikom izvodenja regionalnih ocnih blokova ili kirurskog zahvata. Krvarenje tijekom operacije oka i hemoragijske komplikacije poslije zahvata mogu dovesti do gubitka vidne funkcije ili cak samog oka. S druge strane, prekidanje uzimanja antitrombocitnih i antikoagulacijskih lijekova prije kirurskog zahvata dovodi do povecanog rizika za nastanak ozbiljnih i za zivot opasnih tromboembolijskih komplikacija. Cilj ovoga narativnog preglednog clanka je sustavni pregled objavljenih dokaza o perioperacijskom antitrombotskom lijecenju ocnih bolesnika planiranih za razlicite zahvate u dnevnoj ocnoj kirurgiji. Pretrazene su baze medicinskih podataka pomocu PubMed, Ovid Medline[R] i Google Scholar za razdob