Rebleeding after traumatic hyphema
M. A. Thomas, R. K. Parrish 2nd and W. J. Feuer
We reviewed the medical records of 175 patients who were admitted between
1977 and 1984 with a diagnosis of traumatic hyphema to define the incidence
of operative intervention for the treatment of complications related to
rebleeding. Of the 156 patients admitted with primary hyphemas, 25 (16%)
rebled during hospitalization. Seven of these 25 in-hospital rebleeds
required surgical intervention. Nineteen other patients were admitted with
ocular histories and examinations strongly suggestive of rebleeding prior
to admission (secondary hyphema--presumed preadmission rebleed). Seven of
these 19 eyes underwent surgery. Of the 175 eyes studied, only one eye that
did not rebleed underwent surgery during the initial hospitalization.
Fourteen (32%) of 44 eyes that rebled underwent operative intervention.
Nine of these 14 patients were operated on under general anesthesia.
Potential benefits of newer hyphema treatments, such as
epsilon-aminocaproic acid, designed to prevent rebleeding should be weighed
against not only the ocular risks of rebleeding but also the risks of
general anesthesia.
