Indications for surgical management of hyphema in patients with sickle cell trait
T. A. Deutsch, R. N. Weinreb and M. F. Goldberg
We analyzed 22 sickle cell trait hyphemas. Fourteen of the 22 eyes were
adequately controlled with medical therapy alone, ie, the intraocular
pressure averaged less than 25 mm Hg during consecutive 24-hour periods and
there were no repeated transient rises of IOP above 30 mm Hg. Surgery was
performed in eight eyes, because of inadequate medical control. Thirteen of
the 14 medically treated eyes had acceptable levels of IOP within the first
24 hours; only one of the eight surgically treated eyes had adequate
control during the first 24 hours. This suggests that control during the
first 24 hours portends a good prognosis, while lack of control during that
period predicts continued difficulty managing the IOP. This seems to be
important in view of previous experience that suggests that these eyes do
not tolerate minimal to moderate elevations in IOP as well as those of
patients without sickle cell anemia.
