Effect of Tranexamic Acid on Intra- and Postoperative Bleeding in Eyelid Surgery: A Prospective, Randomized,...

Area of Science:

• Ophthalmology
• Plastic Surgery
• Pharmacology

Background:

• Previous studies indicated a 15-minute wait after subcutaneous tranexamic acid (TXA) injection for eyelid surgery may reduce bleeding and bruising.
• The efficacy of immediate TXA administration without a waiting period in eyelid surgery remained uninvestigated.

Purpose of the Study:

• To evaluate the effectiveness of immediate subcutaneous tranexamic acid (TXA) injection in reducing intraoperative bleeding and postoperative ecchymosis during eyelid surgery.
• To determine if a waiting period is necessary when using TXA for aesthetic and reconstructive eyelid procedures.

Main Methods:

• A prospective, randomized, double-masked, controlled trial involving 130 patients undergoing bilateral eyelid surgery.
• Patients received subcutaneous tranexamic acid (TXA) in one eyelid and a placebo in the contralateral eyelid.
• Outcomes measured included intraoperative bleeding, periocular ecchymosis (graded by masked evaluators), and patient-reported bruising.

Main Results:

• Subcutaneous tranexamic acid (TXA) significantly reduced eyelid ecchymosis at postoperative day 0 and postoperative week 1 (p < 0.001).
• 69% of patients reported less bruising on the TXA-treated side at postoperative week 1 (p < 0.001).
• No significant difference in intraoperative bleeding was observed between the TXA and control sides (p = 0.930).

Conclusions:

• Immediate subcutaneous tranexamic acid (TXA) administration is effective in significantly decreasing postoperative ecchymosis in eyelid surgery.
• TXA did not influence intraoperative bleeding and was not associated with any complications.
• A postinjection waiting period is not required for subcutaneous tranexamic acid to reduce bruising in eyelid surgery.