Intervention Review

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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

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Bedrossian 1974 {published data only}
Christianson 1979 {published data only}
Crouch 1976 {published data only}
Crouch 1997 {published data only}
Edwards 1973 {published data only}
Farber 1991 {published data only}
  • Farber MD, Fiscella R, Goldberg MF. A randomized clinical trial of Amicar vs. prednisone for the treatment of traumatic hyphema. American Academy of Ophthalmology. 1990:119.
  • Farber MD, Fiscella R, Goldberg MF. Aminocaproic acid versus prednisone for the treatment of traumatic hyphema. A randomized clinical trial. Ophthalmology 1991;98(3):279-86.
Karkhaneh 2003 {published data only}
  • Karkhaneh R, Naeeni M, Chams H, Abdollahi M, Mansouri MR. Topical aminocaproic acid to prevent rebleeding in cases of traumatic hyphema. European Journal of Ophthalmology 2003;13(1):57-61.
Kraft 1987 {published data only}
Kutner 1987 {published data only}
  • Anonymous. Traumatic hyphema therapy. Ophthalmology 1988;95(5):707-9.
  • Kutner B, Fourman S, Brein K, Hobson S, Mrvos D, Sheppard J, et al. Aminocaproic acid reduces the risk of secondary hemorrhage in patients with traumatic hyphema. Archives of Ophthalmology 1987;105(2):206-8.
Liu 2002 {published data only}
  • Liu SC, Den JS. The effect of aminomethylbenzoic acid on preventing secondary hyphema. Journal of Eye Injuries and Ophthalmic Occupational Diseases 2002;24(2):127-8.
Marcus 1988 {published data only}
McGetrick 1983 {published data only}
  • Anonymous. Aminocaproic acid. Archives of Ophthalmology 1984;102(6):818, 820-1.
  • McGetrick JJ, Jampol LM, Goldberg MF, Frenkel M, Fiscella RG. Aminocaproic acid decreases secondary hemorrhage after traumatic hyphema. Archives of Ophthalmology 1983;101(7):1031-3.
Palmer 1986 {published data only}
  • Palmer DJ, Goldberg MF, Frenkel M, Fiscella R, Anderson RJ. A comparison of two dose regimens of epsilon aminocaproic acid in the prevention and management of secondary traumatic hyphemas. Ophthalmology 1986;93(1):102-8.
Pieramici 2003 {published data only}
  • Pieramici DJ, Goldberg MF, Melia BM. Topical aminocaproic acid (Caprogel) in the treatment of traumatic hyphema: results of a phase III multicenter placebo controlled trial. Investigative Ophthalmology and Visual Science. 2000; Vol. 41:ARVO Abstract 1616.
  • Pieramici DJ, Goldberg MF, Melia M, Fekrat S, Bradford CA, Faulkner A, et al. A phase III, multicenter, randomized, placebo-controlled clinical trial of topical aminocaproic acid (Caprogel) in the management of traumatic hyphema. Ophthalmology 2003;110(11):2106-12.
Rahmani 1999 {published data only}
  • Rahmani B, Jahadi HR. Comparison of tranexamic acid and prednisolone in the treatment of traumatic hyphema. A randomized clinical trial. Ophthalmology 1999;106(2):375-9.
  • Rahmani B, Jahadi HR, Rajaeefard A. An analysis of risk for secondary hemorrhage in traumatic hyphema. Ophthalmology 1999;106(2):380-5.
  • Rahmani B, Jahadi HR, Salour H. Comparison of tranexamic acid and prednisolone in treatment of traumatic hyphema. American Academy of Ophthalmology. 1997:210.
Rakusin 1972 {published data only}
Read 1974 {published data only}
  • Read J. Traumatic hyphema: surgical vs medical management. Annals of Ophthalmology 1975;7(5):659-62, 664-6, 668-70.
  • Read J, Goldberg MF. Comparison of medical treatment for traumatic hyphema. Transactions of the American Academy of Ophthalmology and Otolaryngology 1974;78(5):OP799-OP815.
Spaeth 1966 {published data only}
  • Spaeth GL, Levy PM. Traumatic hyphema: its clinical characteristics and failure of estrogens to alter its course. A double-blind study. American Journal of Ophthalmology 1966;62(6):1098-106.
Spoor 1980 {published data only}
Sukumaran 1988 {published data only}
  • Sukumaran K. The role of tranexamic acid (Cyklokapron) in the treatment of traumatic hyphaema. Medical Journal of Malaysia 1988;43(2):155-8.
Teboul 1995 {published data only}
  • Teboul BK, Jacob JL, Barsoum-Homsy M, Brunette I, Chevrette L, Milot J, et al. Clinical evaluation of aminocaproic acid for managing traumatic hyphema in children. Ophthalmology 1995;102(11):1646-53.
  • Teboul BK, Jacob JL, Barsoum-Homsy M, Brunette I, Chevrette L, Milot J, et al. Clinical evaluation of aminocaproic acid for the management of traumatic hyphema in children. American Academy of Ophthalmology. 1995:175.
Vangsted 1983 {published data only}
Varnek 1980 {published data only}
Wang 1994 {published data only}
  • Wang XL. Yunnan Baiyao for comtusion hyphema in 45 cases. Jiangsu Journal of Traditional Chinese Medicine 1994;15(7):21.
Welsh 1983 {published data only}
  • Welsh N, Schoeman H, Blignaut P. The effect of cyklokapron in traumatic hyphema. A double masked study. South African Archives of Ophthalmology 1983;10(3-4):67-74.
Zetterstrom 1969 {published data only}
Zi 1999 {published data only}
  • Zi QL. The clinical observation of alternatively right and left lateral position in the cases of hyphema. Journal of Nursing Science 1999;14(5):263-4.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Amirova 1991 {published data only}
  • Amirova EKh, Dubilei OV. Experience in the use of streptodecase in the treatment of intraocular hemorrhage. Vestnik Oftalmologii 1991;107(6):34-6.
Anderson 1971 {published data only}
Berrios 1995 {published data only}
Bramsen 1977 {published data only}
  • Bramsen T. Traumatic eye hemorrhage (hyphema) treated with the antifibrinolytic preparation tranexamic acid. Ugeskrift for Laeger 1977;139(24):1422-4.
Bramsen 1980 {published data only}
  • Bramsen T. The influence of antifibrinolytica on traumatic hyphaema and corneal oedema. Acta Ophthalmologica - Supplementum 1980, (145):1-53.
Campana 1969 {published data only}
  • Campana G, Boschi MC. Clinical and experimental results of the treatment of some ocular diseases with desferrioxamine B. Annali di Ottalmologia e Clinica Oculistica 1969;95(3):200-24.
Cherkasov 1989 {published data only}
  • Cherkasov IS, Pashkovskaia VA, Novik AIa, Shekhab M. Collalysine treatment of intraocular hemorrhages. Oftalmologicheskii Zhurnal 1989, (5):289-90.
Crawford 1976 {published data only}
  • Crawford JS. The effect of aspirin on rebleeding in traumatic hyphema. Transactions of the American Ophthalmological Society 1976;74:357-62.
Dralands 1981 {published data only}
  • Dralands L, De Clippeleir L, Missotten L. The prevention of secondary traumatic hyphema. Bulletin de la Société Belge d'Ophtalmologie 1981;193:77-8.
Dumitrache 2011 {published data only}
  • Dumitrache M, Ciocâlteu AM, Cioboată M, Potop V. Posttraumatic hyphema with secondary glaucoma. Oftalmologia 2011;55(2):50-3.
Gabler 2002 {published data only}
  • Gabler B. Ophthalmological emergencies. 2. Trauma and acute loss of vision. MMW Fortschritte der Medizin 2002;144(45):44-6.
Gastaldi 1970 {published data only}
  • Gastaldi TS, Grassi MS. Treatment of the complications of traumatic hyphema [Tratamiento de las complicaciones del hipema traumatico]. Archivos de Oftalmologia de Buenos Aires 1970;45(11):477-83.
Ghisolfi 1972 {published data only}
  • Ghisolfi A, Manfredini U. Clinical study on a polyenzymic antiinflammatory preparation in some ocular inflammatory conditions [Ricerche cliniche su un antiflogistico polienzimatico in alcune flogosi oculari]. Annali di Ottalmologia e Clinica Oculistica 1972;98(2):69-77.
Gilbert 1973 {published data only}
Gillan 1961 {published data only}
  • Gillan JG. Treatment and prophyaxis of hyphaema by conjugated estrogens. Transactions of the Canadian Ophthalmological Society 1961;24:217-22.
Goldberg 1960 {published data only}
  • Goldberg JL. Conjugated estrogens in the prevention of secondary hyphema after ocular trauma. Archives of Ophthalmology 1960;63(6):127-30.
Gundorova 1985 {published data only}
  • Gundorova RA, Romashchenko AD. Immobilized streptokinase (streptodecase) in the treatment of traumatic intra-ocular hemorrhage. Voprosy Meditsinskoi Khimii 1985;31(4):47-51.
Guseva 2010 {published data only}
  • Guseva MR, Beslaneeva MB. Clinical rationale for the efficiency of using the domestic antioxidant agent Histochrome. Vestnik Oftalmologii 2010;126(3):37-40.
Heath 1966 {published data only}
  • Heath W. Experiences with urokinase in secondary traumatic hyphaema. Transactions of the Ophthalmological Societies of the United Kingdom 1966;86:843-5.
Jrasnov 1986 {published data only}
  • Jrasnov MM, Lariukhina GM, Ronzina IA. Intravitreal use of enzymes in the sequelae of eye injury. Vestnik Oftalmologii 1986;102(1):25-30.
Kirschner 2012 {published data only}
Kotas 1990 {published data only}
  • Kotas R, Neumann D, Ashkenazi I. Epsilon aminocaproic acid for management of traumatic hyphema with large blood clot in the anterior chamber. Harefuah 1990;119(9):269-70.
Krasnov 1971a {published data only}
  • Krasnov AM. Beneficial action of glycerine in traumatic hyphema. Vestnik Oftalmologii 1971;6:43-6.
Krasnov 1971b {published data only}
  • Krasnov AM. Washing the anterior chamber in expressed traumatic hyphema [O promyvanii perednei kamery pri vyrazhennoi travmaticheskoi gifeme]. Oftalmologicheskii Zhurnal 1971;26(2):135-8.
Latinovic 1981 {published data only}
  • Latinovic S, Pellegrino N. Glycerin-vitamin C in the treatment of traumatic hyphema [Glicerolo-vitamina C nel trattamento degli ipoemi traumatici]. Bollettino Chimico Farmaceutico 1981;120(3):156-8.
Li 1997 {published data only}
  • Li SW. Integrated traditional Chinese and western medicine for contusive intraocular hemorrhage in 52 cases. Jiangsu Journal of Traditional Chinese Medicine 1997;18(3):18-9.
Li 2009 {published data only}
  • Li Y, Zhu Y. Clinical study of medication for the treatment of traumatic hyphema. International Journal of Ophthalmology 2009;9(10):2025-6.
Logai 1974 {published data only}
  • Logai IM. Treatment of traumatic hemorrhages into the vitreous body with fibrinolysin in combination with other methods. Oftalmologicheskii Zhurnal 1974;29(4):260-5.
Mathis 1987 {published data only}
  • Mathis A, Malecaze F, Vigne J, Bec P. Treatment of traumatic recurrent hyphema with sodium hyaluronate [Traitement des hyphemas traumatiques recidivants par le hyaluronate de sodium]. Bulletin des Sociétés d'Ophtalmologie de France 1987;87(4):503-4.
Missotten 1977 {published data only}
  • Missotten L, De Clippeleir L, Van Tornout I, Beenders P. The value of tranexamic acid (cyklokapron) in the prevention of secondary bleeding, a complication of traumatic hyphaemia. Bulletin de la Société Belge d'Ophtalmologie 1977;179:47-52.
Mortensen 1978 {published data only}
Munoz Negrete 1989 {published data only}
  • Munoz Negrete FJ, Elosua De Juan I. Prospective study of the efficacy of low dose epsilon aminocaproic acid for the prevention of secondary bleeding after traumatic hyphema. Archivos de la Sociedad Espanola de Oftalmologia 1989;57(2):105-10.
Murzin 1966 {published data only}
  • Murzin AA. Experiences with the use of fibrinolysin and trypsin in intraocular hemorrhages [Opyt primeneniia fibrinolizina i tripsina pri vnutriglaznykh krovoizliianiiakh]. Vestnik Oftalmologii 1966;79(3):19-21.
Ohrstrom 1972 {published data only}
Oksala 1967 {published data only}
Pierse 1964 {published data only}
  • Pierse D. The use of urokinase in the anterior chamber. Transactions of the Ophthalmological Societies of the United Kingdom 1964;84:271-4.
Pogorel'skii 1966 {published data only}
  • Pogorel'skii AI. The use of chemotrypsin in hemophthalmia. Vestnik Oftalmologii 1966;79(3):21-3.
Polychronakos 1967 {published data only}
Rakusin 1971 {published data only}
Roberts 2006 {published data only}
Romano 1986 {published data only}
  • Romano PE. Pro steroids for systemic antifibrinolytic treatment for traumatic hyphema. Journal of Pediatric Ophthalmology and Strabismus 1986;23(2):92-5.
Romashchenko 1985 {published data only}
  • Romashchenko AD, Makarova VP. Experience in treating intraocular hemorrhage using immobilized streptokinase [Opyt lecheniia vnutrioglaznogo krovoizliianiia s pomoshch'iu immobilizovannoi streptokinazy]. Oftalmologicheskii Zhurnal 1985;3:148-51.
Rouher 1966 {published data only}
  • Rouher F, Sole P, Serpin G. Treatment of traumatic intraocular hemorrhages by mannitol. Bulletin des Societes d Ophtalmologie de France 1966;66(4):455-64.
Spoor 1990 {published data only}
Stepanov 2002 {published data only}
  • Stepanov AV, Bolkvadze ER, Belogurov AA, Tovarova II. Prospects for treating intraocular traumatic hemorrhage using a new fibrinolytic hemase [Vozmozhnosti terapii vnutriglaznykh travmaticheskikh krovoizliianii s pomoshch'iu novogo fibrinolitika gemaza]. Vestnik Oftalmologii 2002;118(5):25-7.
Surel 1987 {published data only}
  • Surel Z, Cicekdag E. Tranexamic acid treatment in secondary hemorrhage after traumatic hyphema. Turk Oftalmologji Gazetesi 1987;17(1):49-56.
Tartakovskaia 1972 {published data only}
  • Tartakovskaia AI, Mikhailova NA. Pathogenetic role of fibrinolysis in recurring intra-ocular hemorrhages and their treatment with sigma-aminocapronic acid [Patogeneticheskaia rol' fibrinoliza pri retsidiviruiushchikh vnutriglaznykh krovoizliianiikah i ikh terapiia sigma-aminokapronovoi kislotoi]. Vestnik Oftalmologii 1972;1:41-5.
Travkin 1997 {published data only}
  • Travkin AG, Romashchenko AD. New class of drugs for treatment of eye vascular diseases. Vestnik Oftalmologii 1997;113(6):35-6.
Uusitalo 1988 {published data only}
Volpe 1991 {published data only}
Wang 2010 {published data only}
  • Wang Y-M. Effects of health education on patients with glaucoma secondary to traumatic hyphema. International Journal of Ophthalmology 2010;10(7):1415-6.
Watkins 1974 {published data only}
  • Watkins G, Venable HP. E-Aminocaproic acid in traumatic hyphema. Journal of the National Medical Association 1974;66(6):484-6.
Welsh 1971 {published data only}
  • Welsh N. The management of traumatic glaucoma. South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde 1971;45(44):1250-2.
Williams 1993 {published data only}
Williamson 1973 {published data only}
Wilson 1990 {published data only}
Wright 1964 {published data only}
Yan 2012 {published data only}
  • Yan XY, He P, Liu J, Xia T. Safety discussion of pilocarpine for the treatment of hyphema. International Eye Science 2012;12(9):1797-8.
Yasuna 1974 {published data only}
Zhou 1982 {published data only}
  • Zhou FU. Direct current iontherapy with radix pseudoginseng solution for hyphema. Chinese Journal of Ophthalmology 1982;18(2):83-4.
Zobina 1987 {published data only}
  • Zobina LV, Romashchenko AD. Streptodecase magnetophoresis in the treatment of posttraumatic intraocular hemorrhage. Vestnik Oftalmologii 1987;103(1):51-4.
Zobina 1996 {published data only}
  • Zobina LV, Malkov IuV. Streptodecase magnetophoresis in the Polius-3 treatment of post-traumatic intraocular bleeding. Meditsinskaia Tekhnika 1996, (6):41-2.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Crouch 1993
  • Crouch ER Jr, Williams PB. Trauma: Ruptures and Bleeding. In: Tasman W, Jaeger EM editor(s). Duane's Clinical Ophthalmology. Vol. 4, Philadelphia, PA: JB Lippincott, 1993:1-18.
Crouch 1999
  • Crouch ER Jr, Crouch ER. Management of traumatic hyphema: therapeutic options. Journal of Pediatric Ophthalmology and Strabismus 1999;36(5):238.
Deeks 2011
  • Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta-analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Goldberg 1979a
  • Goldberg MF. Sickled erythrocytes, hyphema, and secondary glaucoma: I. The diagnosis and treatment of sickled erythrocytes in human hyphemas. Ophthalmic Surgery 1979;10(4):17-31.
Goldberg 1979b
  • Goldberg MF, Dizon R, Moses VK. Sickled erythrocytes, hyphema, and secondary glaucoma: VI. The relationship between intracameral blood cells and aqueous humor pH, PO2, and PCO2. Ophthalmic Surgery 1979;10(4):78-88.
Goldberg 1979c
  • Goldberg MF, Tso MO. Sickled erythrocytes, hyphema, and secondary glaucoma: VII. The passage of sickled erythrocytes out of the anterior chamber of the human and monkey eye: light and electron microscopic studies. Ophthalmic Surgery 1979;10(4):89-123.
Higgins 2011
  • Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Lai 2001
RevMan 2012 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
Rhee 1999
  • Rhee D, Pyfer M. The Wills Eye Manual. Lippincott Williams and Wilkins, 1999.
Sheppard 2009
  • Sheppard JD, Crouch ER, Williams PB, Crouch ER Jr, Rastogi S, Garcia-Valenzuela E. Hyphema. Updated: Dec 22, 2009. http://emedicine.medscape.com/1190165.overview (accessed 8 January 2010).
Walton 2002
Westlund 1982
  • Westlund LE, Lundén R, Wallén P. Effect of EACA, PAMBA, AMCA and AMBOCA on fibrinolysis induced by streptokinase, urokinase and tissue activator. Haemostasis 1982;11(4):235-41.
Wright 2003
  • Wright KW. Pediatric ocular trauma: Pediatric hyphema. In: Wright KW, Spiegel PH editor(s). Pediatric Ophthalmology and Strabismus. Vol. 6, Springer, 2003:79-82.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Gharaibeh 2011
Savage 2005
  • Savage HI, Gharaibeh A-M, Mathew MC, Scherer R. Medical interventions for traumatic hyphema. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD005431]