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Medical interventions for traumatic hyphema.

Fasika A Woreta1, Kristina B Lindsley2, Almutez Gharaibeh3

  • 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

The Cochrane Database of Systematic Reviews
|March 13, 2023
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Summary
This summary is machine-generated.

Traumatic hyphema treatments show no improvement in visual acuity. Antifibrinolytic agents like aminocaproic acid may reduce rebleeding but can prolong healing time and cause side effects.

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Area of Science:

  • Ophthalmology
  • Trauma Care
  • Clinical Trials

Background:

  • Traumatic hyphema involves blood in the anterior eye chamber after injury.
  • Complications include increased intraocular pressure and vision loss, especially in sickle cell patients.
  • Rebleeding exacerbates complications and severity.

Purpose of the Study:

  • To evaluate the effectiveness of medical interventions for traumatic hyphema.
  • To assess impacts on visual acuity and secondary hemorrhage rates.

Main Methods:

  • Systematic review and meta-analysis of randomized and quasi-randomized trials.
  • Searched multiple databases including Cochrane, MEDLINE, Embase, and PubMed.
  • Included 30 studies with 2969 participants evaluating various non-surgical treatments.

Main Results:

  • No intervention demonstrated an effect on visual acuity (short or long-term).
  • Systemic and topical aminocaproic acid, and systemic tranexamic acid reduced secondary hemorrhage rates.
  • Aminocaproic acid use was linked to increased nausea and vomiting; systemic use prolonged hyphema resolution.

Conclusions:

  • Current evidence does not support most interventions for improving visual acuity in traumatic hyphema.
  • Antifibrinolytic agents may reduce rebleeding, but benefits versus risks require further study.
  • More research is needed on combined interventions and long-term effects of secondary hemorrhage.