Cataract Surgery in Patients with Left Ventricular Assist Devices.

PURPOSE: To determine the safety and efficacy of cataract surgery in patients with left ventricular assist devices (LVADs). SETTING: Duke Eye Center, Durham, NC, USA. DESIGN: Retrospective case series. METHODS: Electronic medical records were used to collect patient demographics, preoperative planning, intraoperative details, and postoperative outcomes of patients with LVADs who underwent cataract surgery between March 2012 and August 2019.. RESULTS: Fifty-three cataract surgeries were identified involving 31 patients. Most patients were male (n = 27) and Caucasian (n =25) with an average age of 69.5 years. Preoperative biometry was unchanged from standard protocol. Femtosecond laser, intraoperative aberrometry, and/or a premium intraocular lens implant was utilized in 47.2% of cases (n=25). Patients were on warfarin, warfarin plus aspirin, and warfarin plus clopidogrel in 51.6%, 45.2%, and 3.2% of cases, respectively. Patients underwent topical anesthesia with monitored anesthesia care from an experienced LVAD team as planned with no episodes of hemodynamic instability, respiratory compromise, or intraoperative adverse events related to the LVAD. All patients were discharged the same day as surgery. There were no hospitalizations or deaths within 30 days that were attributed to the cataract procedure. At 1 month postoperatively, 61.1% of eyes were +/-0.5 diopter of their predicted spherical equivalent (n=11/18), with a high proportion of patients returning to local providers for postoperative care. CONCLUSIONS: Cataract surgery was safe and feasible in patients with LVADs when performed with additional perioperative considerations and in conjuction of an experienced LVAD team. The presence of an LVAD itself was not found to not be a contraindication for cataract surgery.