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Abstract • 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. References 1. Thygeson P, Beard C: Observations on traumatic hyphema . Am J Ophthalmol 1952;35:977-985. 2. Henry MM: Nonperforating eye injuries with hyphema . Am J Ophthalmol 1960;49:1298-1300. 3. Gregersen E: Traumatic hyphema: Report of 200 successive cases . Acta Ophthalmol 1962;40:192-201.Crossref 4. Coles WH: Traumatic hyphema: An analysis of 235 cases . South Med J 1968;61:813-816.Crossref 5. Bengtsson E, Ehinger B: Treatment of traumatic hyphema . Acta Ophthalmol 1975;53:914-923.Crossref 6. Thomas M, Parrish R, Feuer W: Rebleeding after traumatic hyphema . Arch Ophthalmol 1986;104:206-210.Crossref 7. Yasuna E: Management of traumatic hyphema . Arch Ophthalmol 1974;91:190-191.Crossref 8. Oksala A: Treatment of traumatic hyphema . Br J Ophthalmol 1967;51:315-320.Crossref 9. Spoor T, Hammer M, Belloso H: Traumatic hyphema: Failure of steroids to alter its course: A double-blind prospective study . Arch Ophthalmol 1980;98:116-119.Crossref 10. Crouch ER, Frenkel M: Aminocaproic acid in the treatment of traumatic hyphema . Am J Ophthalmol 1976;81:355-363. 11. Varnek L, Dalsgaard C, Hansen A, et al: The effect of tranexamic acid on secondary hemorrhage after traumatic hyphema . Acta Ophthalmol 1980;58:787-793.Crossref 12. Uusitalo RJ, Saari MS, Aine E, et al: Tranexamic acid in the prevention of secondary hemorrhage after traumatic hyphema . Acta Ophthalmol 1981;59:539-545.Crossref 13. McGetrick JJ, Jampol LM, Goldberg MF, et al: Aminocaproic acid decreases secondary hemorrhage after traumatic hyphema . Arch Ophthalmol 1983;101:1031-1033.Crossref 14. Vangsted P, Nielsen PJ: Tranexamic acid and traumatic hyphema . Acta Ophthalmol 1983;61:447-453.Crossref 15. Palmer DJ, Goldberg MF, Frenkel M, et al: A comparison of two dose regimens of epsilon aminocaproic acid in the prevention and management of secondary traumatic hyphemas . Ophthalmology 1986;93:102-108.Crossref 16. Kutner B, Fourman S, Brein K, et al: Aminocaproic acid reduces the risk of secondary hemorrhage in patients with traumatic hyphema . Arch Ophthalmol 1987;105:206-208.Crossref 17. Öhrström A: Treatment of traumatic hyphema with corticosteroids and mydriatics . Acta Ophthalmol 1972;50:549-555.Crossref 18. Agapitos PJ, Noel L, Clarke WN: Traumatic hyphema in children . Ophthalmology 1987;94:1238-1241.Crossref 19. Loewy DM, Williams PB, Crouch ER, et al: Systemic aminocaproic acid reduces fibrinolysis in aqueous humour . Arch Ophthalmol 1987;105:272-276.Crossref 20. Kraft SP, Christianson MD, Crawford JS, et al: Traumatic hyphema in children . Ophthalmology 1987;94:1232-1237.Crossref 21. Wilson FM: Traumatic hyphema: Pathogenesis and management . Ophthalmology 1980;87:910-919.Crossref
Archives of Ophthalmology – American Medical Association
Published: Sep 1, 1988
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