Influence of cataract extraction on coagulation and fibrinolysis
Muto, M.
Nippon Ganka Gakkai Zasshi 83(11): 2112-2125
1979
ISSN/ISBN: 0029-0203 PMID: 546200 Document Number: 151824
The effects of cataract extraction on blood coagulation and fibrinolysis system I were examined in 48 cataract extraction patients aged 39-83 yr on 6 occasions: the day before, 2 h after, and at intervals 1 day after, 1 wk after, 2 wk after and 3 wk after surgery. No changes in blood coagulation time or fibrinolytic activity were seen, but a significant increase in plasma fibrinogen (Fbg) occurred during the 2 wk period after surgery (P < 0.001). The possible causes for the increased levels of Fbg after cataract extraction were examined. The possibility that increase of Fbg may be related to prostaglandins (PG) at the affected part of the eye was tested by making subconjunctival injections of PG in 11 domestic rabbits, and measuring Fbg levels before and after injections. A subconjunctival injection of PGE1 (0.2 mg/kg) resulted in a significant increase of Fbg (P < 0.05). Observations were made on 33 cataract extraction patients aged 34-82 yr to whom a PG biosynthesis inhibitor, aspirin, was given at a dose of 1 g/day from the day before to 2 wk after surgery. Blood coagulation and fibrinolysis system were measured before and after surgery. The findings did not show any increase in the amount of Fbg in these patients. The probability that PG was related to increase of Fbg following cataract extraction was considered. The clinical significance of the Fbg increase after cataract extraction was discussed, and data on the occurrence of cystoid macular edema (CME), the most frequent blood vessel complication following cataract surgery, were reviewed. The incidence of CME was significantly higher in patients with Fbg above the normal range. The increase in Fbg following cataract extraction might be mediated by the production of PG in the affected part of the eye, and increased Fbg was clinically significant in its relationship to the occurrence of CME.