{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:20:59Z","timestamp":1770906059493,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,6,24]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>Clear guidelines for managing patients on antiplatelet (AP) or anticoagulant (AC) therapy undergoing oculoplastic surgery are lacking. This study investigates bleeding risk factors and evaluates the effectiveness of a standardised bleeding risk assessment in extraocular surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, a standardised questionnaire (SQ) was employed to gather patients\u2019 bleeding histories. Associations between SQ scores and preoperative\/demographic factors (AP\/AC use, age, sex, comorbidities), and surgical factors (blood pressure, surgery type, primary vs revision surgery, anaesthesia type, duration, pain management) were assessed. A scoring system quantified bleeding severity. Patients were monitored postoperatively for 24 hours (eyelid procedures) to 3 or 4\u2009days (orbital\/nasolacrimal surgery).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 324 patients (aged 18\u201392) were included (252 eyelid, 56 orbital and 16 nasolacrimal surgeries). 87 patients were using AP, AC and\/or herbal supplements. Severe bleeding occurred in 35 patients, four required revision surgery, though none suffered permanent damage. Bleeding complications were significantly associated with higher SQ scores (p=0.048), acetylsalicylic acid use in eyelid surgery (p=0.038), diabetes mellitus (p=0.016), renal disease (p=0.044), general anaesthesia (p=0.001) and longer surgery duration (p=0.007). Local anaesthesia, AC use and systolic hypertension were not significantly associated with bleeding risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SQ is a valuable tool for assessing bleeding risk in oculoplastic patients. Findings support future multicentre studies to develop evidence-based perioperative guidelines for AP and AC management. Limitations include cohort heterogeneity, small sample size, non-blinded design and subjective bleeding scores affecting comparability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2024-326553","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T17:20:21Z","timestamp":1753204821000},"page":"1330-1337","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Risk factors for bleeding and perioperative bleeding complications in oculoplastic surgery: a prospective pilot study"],"prefix":"10.1136","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5494-1006","authenticated-orcid":false,"given":"Nike Annika","family":"Christensen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6857-3003","authenticated-orcid":false,"given":"Nicolas","family":"Feltgen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1990-9218","authenticated-orcid":false,"given":"Maren","family":"Horn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4657-8620","authenticated-orcid":false,"given":"Sabine","family":"Naxer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3237-3803","authenticated-orcid":false,"given":"Christian","family":"van Oterendorp","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6658-8017","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Koscielny","sequence":"additional","affiliation":[{"name":"Institute for Transfusion Medicine, Charite University Hospital Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5346-242X","authenticated-orcid":false,"given":"Christoph","family":"Sucker","sequence":"additional","affiliation":[{"name":"Internal Medicine, Brandenburg Medical School Theodor Fontane Ruppin Clinics, Neuruppin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4458-0292","authenticated-orcid":false,"given":"Sebastian","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Ingress-Health HWM GmbH, Wismar, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8634-9101","authenticated-orcid":false,"given":"Fabian","family":"K\u00fcck","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, University Medical Center G\u00f6ttingen, Gottingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6504-9532","authenticated-orcid":false,"given":"Michael P","family":"Schittkowski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center G\u00f6ttingen, Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"2025112002101394000_109.12.1330.1","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1007\/s00347-016-0368-8","article-title":"Thrombozytenaggregationshemmer und Antikoagulantien bei augenchirurgischen Eingriffen","volume":"113","author":"Feltgen","year":"2016","journal-title":"Ophthalmologe"},{"key":"2025112002101394000_109.12.1330.2","unstructured":"Wolfram C , Pfeiffer N . 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