INCIDENCE OF SECONDARY HYPHEMA - DEPENDING ON THE INITIAL HYPHEMA LEVEL

97th DOG Annual Meeting 1999

P519
INCIDENCE OF SECONDARY HYPHEMA - DEPENDING ON THE INITIAL HYPHEMA LEVEL

A. Viestenz, M. Küchle

Background: About 80% of the eyes with blunt trauma develop a hyphema. The rebleeding during the first week is very problematical. We explored a possible relationship between the initial hyphema level and the incidence of secondary bleeding.

Patients and Methods: In this retrospective study patients that were hospitalized for blunt ocular trauma with or without hyphema were included. The mean age was 29±15 years, 86% were males. We devided the hyphema height of the 275 patients into two groups: lower and more than half of the anterior chamber.

Results: All 52 patients without hyphema had no rebleedings. 3 of the 210 patients with a hyphema lower than half of the anterior chamber developed a secondary hyphema (1,4%). 31% of 13 patients with a more than half of the anterior chamber filling initial hyphema developed a secondary bleeding. This difference was highly significant (chi-square-test: p<0,00001). The maximal risk of rebleeding was on the third day.

Conclusions: Eyes with a hyphema filling more than half of the anterior chamber have a very high risk of rebleedings. A red- or black-ball-hyphema follows very often - with extreme high intraocular pressures. For these patients we recommend frequent follow-up visits and - if possible - hospitalization to remove the blood clot (on 5th day) and prevent further complications.

Department of Ophthalmology of the University Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen, Germany

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