Tranexamic acid does not seem to lower rebleed rate in pediatric traumatic hyphema

Treating children with traumatic hyphema with tranexamic acid plus topical steroids does not appear to significantly lower the incidence of rebleed compared to treatment with topical steroids alone, a retrospective study suggests.

David A. Albiani, MD, and colleagues compared treatment results, including visual acuity, rebleed rate, IOP and time to hyphema resolution, for 215 pediatric patients who had been treated for traumatic hyphema with either Cyklokapron (tranexamic acid, Pfizer) combined with topical steroids or topical steroids alone. Specifically, 137 patients (63.1%) received tranexamic acid in three oral doses of 25 mg/kg combined with topical steroids for a duration of 5 days and 78 patients received topical steroids alone.

The investigators found no significant difference in rebleed rate between patients treated with tranexamic acid plus topical steroids (two patients; 1.6%) and patients treated with steroids alone (two patients; 2.6%).

They also found no significant difference in visual acuity between groups at baseline and at final follow-up; however, visual acuity improved more rapidly in patients who received steroids alone, according to the study, published in the July issue of Canadian Journal of Ophthalmology.