Intervention Review

You have free access to this content

Medical interventions for traumatic hyphema

  1. Almutez Gharaibeh1,
  2. Howard I Savage2,
  3. Roberta W Scherer3,*,
  4. Morton F Goldberg4,
  5. Kristina Lindsley5

Editorial Group: Cochrane Eyes and Vision Group

Published Online: 3 DEC 2013

Assessed as up-to-date: 30 AUG 2013

DOI: 10.1002/14651858.CD005431.pub3


How to Cite

Gharaibeh A, Savage HI, Scherer RW, Goldberg MF, Lindsley K. Medical interventions for traumatic hyphema. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD005431. DOI: 10.1002/14651858.CD005431.pub3.

Author Information

  1. 1

    Faculty of Medicine, The University of Jordan, Department of Special Surgery-Ophthalmology, Amman, Jordan

  2. 2

    Kaiser Permanente Largo Medical Center, Largo, Maryland, USA

  3. 3

    Johns Hopkins University Bloomberg School of Public Health, Center for Clinical Trials, Baltimore, MD, USA

  4. 4

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

  5. 5

    Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA

*Roberta W Scherer, Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Health, Room W5010, 615 N. Wolfe St., Baltimore, MD, 21205, USA. rscherer@jhsph.edu.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 3 DEC 2013

SEARCH

[Figure 1]
Figure 1. Study flow diagram for 2013 update of literature searches.
[Figure 2]
Figure 2. Methodologic quality summary: review authors' judgments about each methodologic quality item for each included study. Green: low risk of bias; red: high risk of bias; yellow: unclear risk of bias.
[Figure 3]
Figure 3. Forest plot of comparison: 1 Oral aminocaproic acid versus placebo, outcome: 1.5 Secondary hemorrhage.
[Figure 4]
Figure 4. Forest plot of comparison: 5 Tranexamic acid versus control, outcome: 5.1 Short-term visual acuity from 20/20 to 20/40.
[Figure 5]
Figure 5. Forest plot of comparison: 5 Tranexamic acid versus control, outcome: 5.3 Secondary hemorrhage.
[Figure 6]
Figure 6. Forest plot of comparison: 5 Tranexamic acid versus control, outcome: 5.6 Incidence of glaucoma or increased intraocular pressure (IOP).
[Analysis 1.1]
Analysis 1.1. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 1 Long-term visual acuity between 20/20 and 20/40.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 2 Short-term visual acuity from 20/20 to 20/40.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 3 Final visual acuity between 20/20 and 20/40.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 4 Time to resolution of primary hemorrhage (days).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 5 Risk of secondary hemorrhage.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 6 Time to rebleed (days).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 7 Risk of corneal bloodstain.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 8 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 1.9]
Analysis 1.9. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 9 Risk of glaucoma or increases in IOP.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 10 Risk of optic atrophy.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 11 Adverse effects: nausea or vomiting.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Oral aminocaproic acid versus placebo, Outcome 12 Duration of hospitalization (days).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Topical aminocaproic acid versus placebo, Outcome 1 Short-term visual acuity from 20/20 to 20/40.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Topical aminocaproic acid versus placebo, Outcome 2 Time to resolution of primary hemorrhage (days).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Topical aminocaproic acid versus placebo, Outcome 3 Risk of secondary hemorrhage.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Topical aminocaproic acid versus placebo, Outcome 4 Time to rebleed (days).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Topical aminocaproic acid versus placebo, Outcome 5 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 1 Unspecified time for visual acuity between 20/20 and 20/40.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 2 Time to resolution of primary hemorrhage (days).
[Analysis 3.3]
Analysis 3.3. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 3 Risk of secondary hemorrhage.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 4 Time to rebleed (days).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 5 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 3.6]
Analysis 3.6. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 6 Adverse effects.
[Analysis 3.7]
Analysis 3.7. Comparison 3 Low-dose versus standard-dose aminocaproic acid, Outcome 7 Duration of hospitalization (days).
[Analysis 4.1]
Analysis 4.1. Comparison 4 Oral versus topical aminocaproic acid, Outcome 1 Short-term visual acuity from 20/20 to 20/40.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Oral versus topical aminocaproic acid, Outcome 2 Risk of secondary hemorrhage.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Oral versus topical aminocaproic acid, Outcome 3 Time to rebleed (days).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Oral versus topical aminocaproic acid, Outcome 4 Risk of corneal bloodstain.
[Analysis 4.5]
Analysis 4.5. Comparison 4 Oral versus topical aminocaproic acid, Outcome 5 Risk of optic atrophy.
[Analysis 4.6]
Analysis 4.6. Comparison 4 Oral versus topical aminocaproic acid, Outcome 6 Adverse effects.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Tranexamic acid versus control, Outcome 1 Short-term visual acuity from 20/20 to 20/40.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Tranexamic acid versus control, Outcome 2 Time to resolution of primary hemorrhage (days).
[Analysis 5.3]
Analysis 5.3. Comparison 5 Tranexamic acid versus control, Outcome 3 Risk of secondary hemorrhage.
[Analysis 5.4]
Analysis 5.4. Comparison 5 Tranexamic acid versus control, Outcome 4 Time to rebleed (days).
[Analysis 5.5]
Analysis 5.5. Comparison 5 Tranexamic acid versus control, Outcome 5 Risk of corneal bloodstain.
[Analysis 5.6]
Analysis 5.6. Comparison 5 Tranexamic acid versus control, Outcome 6 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 5.7]
Analysis 5.7. Comparison 5 Tranexamic acid versus control, Outcome 7 Risk of optic atrophy.
[Analysis 5.8]
Analysis 5.8. Comparison 5 Tranexamic acid versus control, Outcome 8 Adverse effects: nausea or vomiting.
[Analysis 5.9]
Analysis 5.9. Comparison 5 Tranexamic acid versus control, Outcome 9 Duration of hospitalization (days).
[Analysis 6.1]
Analysis 6.1. Comparison 6 Aminomethylbenzoic acid versus placebo, Outcome 1 Risk of secondary hemorrhage.
[Analysis 7.1]
Analysis 7.1. Comparison 7 Oral corticosteroids versus control, Outcome 1 Short-term (5-14 day) visual acuity from 20/20 to 20/40.
[Analysis 7.2]
Analysis 7.2. Comparison 7 Oral corticosteroids versus control, Outcome 2 Visual acuity between 20/20 and 20/50 at resolution of hyphema.
[Analysis 7.3]
Analysis 7.3. Comparison 7 Oral corticosteroids versus control, Outcome 3 Time to resolution of primary hemorrhage (days).
[Analysis 7.4]
Analysis 7.4. Comparison 7 Oral corticosteroids versus control, Outcome 4 Risk of secondary hemorrhage.
[Analysis 7.5]
Analysis 7.5. Comparison 7 Oral corticosteroids versus control, Outcome 5 Time to rebleed (days).
[Analysis 7.6]
Analysis 7.6. Comparison 7 Oral corticosteroids versus control, Outcome 6 Risk of corneal bloodstain.
[Analysis 7.7]
Analysis 7.7. Comparison 7 Oral corticosteroids versus control, Outcome 7 Risk of peripheral anterior synechiae.
[Analysis 7.8]
Analysis 7.8. Comparison 7 Oral corticosteroids versus control, Outcome 8 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 7.9]
Analysis 7.9. Comparison 7 Oral corticosteroids versus control, Outcome 9 Duration of hospitalization (days).
[Analysis 8.1]
Analysis 8.1. Comparison 8 Topical corticosteroids versus control, Outcome 1 Short-term (5-14 day) visual acuity from 20/20 to 20/40.
[Analysis 8.2]
Analysis 8.2. Comparison 8 Topical corticosteroids versus control, Outcome 2 Time to resolution of primary hemorrhage (days).
[Analysis 8.3]
Analysis 8.3. Comparison 8 Topical corticosteroids versus control, Outcome 3 Risk of secondary hemorrhage.
[Analysis 8.4]
Analysis 8.4. Comparison 8 Topical corticosteroids versus control, Outcome 4 Risk of corneal bloodstain.
[Analysis 8.5]
Analysis 8.5. Comparison 8 Topical corticosteroids versus control, Outcome 5 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 8.6]
Analysis 8.6. Comparison 8 Topical corticosteroids versus control, Outcome 6 Risk of optic atrophy.
[Analysis 8.7]
Analysis 8.7. Comparison 8 Topical corticosteroids versus control, Outcome 7 Duration of hospitalization (days).
[Analysis 9.1]
Analysis 9.1. Comparison 9 Aminocaproic acid versus prednisone, Outcome 1 Short-term (5-14 day) visual acuity from 20/20 to 20/40.
[Analysis 9.2]
Analysis 9.2. Comparison 9 Aminocaproic acid versus prednisone, Outcome 2 Risk of secondary hemorrhage.
[Analysis 9.3]
Analysis 9.3. Comparison 9 Aminocaproic acid versus prednisone, Outcome 3 Adverse effect: any adverse event.
[Analysis 10.1]
Analysis 10.1. Comparison 10 Conjugated estrogen versus placebo, Outcome 1 Risk of secondary hemorrhage.
[Analysis 10.2]
Analysis 10.2. Comparison 10 Conjugated estrogen versus placebo, Outcome 2 Risk of corneal bloodstain.
[Analysis 11.1]
Analysis 11.1. Comparison 11 Cycloplegics versus miotics, Outcome 1 Short-term visual acuity.
[Analysis 11.2]
Analysis 11.2. Comparison 11 Cycloplegics versus miotics, Outcome 2 Time to resolution of primary hemorrhage (days).
[Analysis 11.3]
Analysis 11.3. Comparison 11 Cycloplegics versus miotics, Outcome 3 Risk of secondary hemorrhage.
[Analysis 11.4]
Analysis 11.4. Comparison 11 Cycloplegics versus miotics, Outcome 4 Time to rebleed (days).
[Analysis 12.1]
Analysis 12.1. Comparison 12 Aspirin versus observation, Outcome 1 Risk of secondary hemorrhage.
[Analysis 13.1]
Analysis 13.1. Comparison 13 Monocular versus binocular patching, Outcome 1 Short-term visual acuity.
[Analysis 13.2]
Analysis 13.2. Comparison 13 Monocular versus binocular patching, Outcome 2 Variable time length 'final' visual acuity.
[Analysis 13.3]
Analysis 13.3. Comparison 13 Monocular versus binocular patching, Outcome 3 Risk of secondary hemorrhage.
[Analysis 13.4]
Analysis 13.4. Comparison 13 Monocular versus binocular patching, Outcome 4 Time to rebleed (days).
[Analysis 13.5]
Analysis 13.5. Comparison 13 Monocular versus binocular patching, Outcome 5 Risk of corneal bloodstain.
[Analysis 13.6]
Analysis 13.6. Comparison 13 Monocular versus binocular patching, Outcome 6 Risk of glaucoma or elevated intraocular pressure (IOP).
[Analysis 14.1]
Analysis 14.1. Comparison 14 Ambulatory versus conservative treatment, Outcome 1 Short-term visual acuity.
[Analysis 14.2]
Analysis 14.2. Comparison 14 Ambulatory versus conservative treatment, Outcome 2 Time to resolution of primary hemorrhage.
[Analysis 14.3]
Analysis 14.3. Comparison 14 Ambulatory versus conservative treatment, Outcome 3 Risk of secondary hemorrhage.
[Analysis 14.4]
Analysis 14.4. Comparison 14 Ambulatory versus conservative treatment, Outcome 4 Risk of corneal bloodstain.
[Analysis 14.5]
Analysis 14.5. Comparison 14 Ambulatory versus conservative treatment, Outcome 5 Risk of glaucoma or elevated intraocular pressure (IOP).