Medical Treatment in Prevention of Rebleeding in Traumatic Hyphema

Document Type : Research Paper




ntroduction: Traumatic hyphema is among the most common challenges in ophthalmologic emergency. Its most common complication, rebleeding, is accompanied with poor prognosis. Rebleeding could cause corneal blood staining, glaucoma, and optic atrophy. Thus, the most important goal in hyphema treatment is prevention of rebleeding. This study was aimed to evaluate epidemiology, medical treatment, and short term complications of traumatic hyphema.
Material and Methods: This was a descriptive cross-sectional study, done in the year in Khatam- al- Anbia Ophthalmologic Hospital in Mashhad. 100 patients with traumatic hyphema were evaluated by an epidemiologic questionnaire and complete eye examination in emergency room. They all were treated by topical corticosteroid and cycloplegic with or without systemic medication (prednisone or tranexamic acid) according to degree of hyphema .All patients were followed for at least 10 days. Data was analyzed, using descriptive statistics and frequency distribution tables.
Results: 81% of patients were male with male to female ratio of 4:1. The patients’ mean age was 26.5+/-15.4 years old. 62% of patients were under 30 years of age. The patients’ right and left eyes were affected in 48% and 50%, respectively; 2% had both eyes affected. No statistically significant difference was found between right and left eye involvement. The mean visual acuity at presenting time was 4/10. There was a direct correlation between presenting visual acuity and severity of hyphema (p=0.043). No correlation was found between age, sex, and the type of trauma with severity of hyphema. The mean intraocular pressure (IOP) was 18 mmHg at presenting time. There wasn't any correlation between IOP and severity of hyphema. The mean visual acuity at the last follow up visit was 8/10. Rebleeding occurred in 10 patients out of 100 cases. The risk of rebleeding with medical treatment was 10%. Rebleeding was found to occur 4.3 days after trauma, averagely. In this study, it was seen in the cases with hyphema of the degree of 4 or more (the only risk factor for rebleeding, in this study).
Conclusion: Traumatic hyphema is a common cause of refer to ophthalmology emergency room. Results of this study showed that complications of traumatic hyphema, especially rebleeding, could be prevented, significantly, with medical treatment.


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