Ophthalmic surgery
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The usual management of traumatic hyphemas in our institution has been to avoid or delay surgery until absolutely demanded by the clinical course. Despite this, most (73%) of our in-patients with total hyphema underwent surgery before leaving the hospital. In those who required surgery, 43% developed corneal staining. ⋯ The usual procedure used in this series was a trabeculectomy with iridectomy and gentle irrigation of the anterior chamber, and no surgical complications occurred. We believe that surgery, being relatively safe, should be performed early in cases of total hyphema unless the elevated intraocular pressure is controlled medically and spontaneous resolution is clearly imminent. For cases in which surgery is nearly inevitable, we suggest that earlier surgery might reduce the incidence of optic nerve damage and corneal staining.