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Letter
Acquired Glanzmann’s thrombasthenia causing prolonged bleeding following phacoemulsification
  1. S Dinakaran1,
  2. M P Edwards1,
  3. K K Hampton2
  1. 1Department of Ophthalmology, A-Floor, Royal Hallamshire Hospital, Sheffield, UK
  2. 2Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK
  1. Correspondence to: S Dinakaran, Department of Ophthalmology, A-Floor, Royal Hallamshire Hospital, Sheffield, UK; sdinakaran{at}yahoo.com

https://doi.org/10.1136/bjo.87.9.1189

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    Phacoemulsification under topical anaesthesia using clear corneal incision is not a challenging procedure for the haemostatic system. In patients with known bleeding diathesis, this may be the procedure of choice to remove cataract. We report a patient who bled continuously for 36 hours following phacoemulsification under topical anaesthesia through a clear corneal incision. This was managed by using a topical haemostatic agent that has not been used in ophthalmic surgery before. Extensive haematological evaluation revealed the underlying cause to be an acquired form of Glanzmann’s thrombasthenia, a very rare condition.1,2

    Case report

    A 79 year old woman underwent left phacoemulsification with intraocular lens implantation under topical anaesthesia through a clear corneal temporal incision. The procedure was uneventful but she was seen to bleed from the operated eye in the recovery room. The eye was patched but the bleeding continued soaking the pads. When re-examined 2 hours later, as there was continuous bleeding, the eye was patched with gentle pressure. Examination the next day showed that the bleeding was persistent. …

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