Management of traumatic hyphema in children. An analysis of 340 cases

Three hundred forty children with nonperforating traumatic hyphema were examined to verify or refute the possible protective action of the antifibrinolytic agent, tranexamic acid, against rebleeding. In the retrospective study group, 219 children were treated with strict bed rest, binocular patching, and sedation but did not receive antifibrinolytic agents. In the prospective study group, 121 children received systemically administered tranexamic acid; some of these children were confined to bed rest (26 cases) and some were allowed free ambulation within their rooms (95 cases). In the children who were treated with bed rest but who did not receive the antifibrinolytic agent, the frequency of secondary hemorrhage was 9.6%. Tranexamic acid reduced the incidence of secondary hemorrhage significantly: none of 26 eyes of patients who received systemically administered tranexamic acid and were confined to bed rest rebled, and only one (1.1%) of 95 eyes of children who received tranexamic acid and were allowed free ambulation in the hospital rebled.