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Secondary hemorrhage in traumatic hyphema.
N J Volpe1, W I Larrison, P S Hersh
1Eye Emergency Department, Massachusetts Eye and Ear Infirmary, Boston.
American Journal of Ophthalmology
|November 15, 1991
Summary
Systemic aminocaproic acid did not reduce secondary hemorrhage rates in traumatic hyphema patients. Early examination is key, as later assessment showed a higher risk of hemorrhage and permanent vision loss from macular injury.
Area of Science:
- Ophthalmology
- Trauma Care
Background:
- Traumatic hyphema can lead to secondary hemorrhage, potentially causing vision loss.
- Systemic aminocaproic acid is sometimes used to prevent bleeding complications.
Purpose of the Study:
- To compare the incidence of secondary hemorrhage in traumatic hyphema patients treated with or without systemic aminocaproic acid.
- To evaluate the efficacy of aminocaproic acid in preventing secondary hemorrhage following traumatic hyphema.
Main Methods:
- Retrospective analysis of 132 hospitalized patients with traumatic hyphema.
- Comparison of secondary hemorrhage rates between patients receiving and not receiving systemic aminocaproic acid.
- Stratification of analysis based on timing of patient examination post-injury.
Main Results:
- No significant difference in secondary hemorrhage rates was observed between aminocaproic acid-treated (4.8%) and untreated (5.4%) patients examined within one day of injury (P = .31).
- Patients examined more than one day after injury had a significantly higher secondary hemorrhage rate (38.5%).
- All patients with secondary hemorrhage achieved good visual acuity; permanent vision loss was primarily due to macular injury.
Conclusions:
- Systemic aminocaproic acid administration did not demonstrate a detectable benefit in reducing secondary hemorrhage in this patient population.
- Early examination post-injury appears crucial for managing traumatic hyphema and preventing complications.
- Further research is needed to identify specific patient subgroups who may benefit from aminocaproic acid treatment, considering its side effects and cost.