Ophthalmology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of tranexamic acid and prednisolone in the treatment of traumatic hyphema. A randomized clinical trial.
Oral antifibrinolytics, oral steroids, and no oral treatment are the preferred medical treatments for traumatic hyphema. Antifibrinolytics and steroids have decreased the chance of rebleeding in some studies but failed to alter the clinical course in others. Rate of secondary hemorrhage seems variable among different geographic and ethnic groups of patients. Comparison of the treatments in each population is necessary to document the most effective method of preventing recurrent hemorrhage. ⋯ In a population with a high rate of secondary bleeding, TA is more effective than oral prednisolone or no oral treatment in preventing rebleeding among patients with traumatic hyphema.
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Randomized Controlled Trial Clinical Trial
An analysis of risk for secondary hemorrhage in traumatic hyphema.
Factors such as size of hyphema, intraocular pressure, initial visual acuity, and use of steroids or antifibrinolytic drugs may be associated with the likelihood of rebleeding in traumatic hyphema. The association of the visual outcome with secondary hemorrhage has been questioned. ⋯ High intraocular pressure and low vision at the time of first examination may be associated with increased chance of rebleeding. Retinal damage, secondary hemorrhage, male gender, and initial poor vision are associated with a worse visual outcome in patients with traumatic hyphema.
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To evaluate the accuracy and repeatability of the widely used comparison method of measuring pupil size. ⋯ Results indicate that although the mean difference in techniques was small, the range of the agreement between the Rosenbaum and the infrared techniques was large. The Rosenbaum method consistently overestimated pupil diameters and was subject to inter-rater repeatability bias. Rosenbaum pupillometry may not be appropriate when accurate pupil measurements are required. The results have implications for many clinical trials in ophthalmology, including those evaluating refractive surgery that use Rosenbaum comparison pupillometry.