Comparison between topical and oral tranexamic acid in management of traumatic hyphema

Background: We sought to determine the efficacy of topical tranexamic acid [5%] in the management of traumatic hyphema

Methods: Thirty eyes with gross traumatic hyphema were enrolled in this study. The patients were treated with tranexamic acid [5%] eye drop every 6 hours for 5 days. The main outcome measures were best corrected visual acuity [BCVA], Intra-ocular pressure [IOP], day of clot absorption, and rate of rebleeding. These parameters were evaluated daily for 4 days and thereafter at the 8[th] and 14[th] days after treatment. The patients were also compared with two historical control groups of patients [80 eyes] with traumatic hyphema; the first control group was treated with oral placebo and the other group was treated with oral tranexamic acid at our department

Result: Prior to treatment, the mean logarithm of the minimum angle of resolution [logMAR] BCVA was 0.59 +/- 0.62. BCVA was increased to 0.08 +/- 0.14 at day 14 [P<0.001] and the mean IOP before treatment was 13.7 +/- 3.9 mm Hg, which was reduced to 11.4 +/- 1.8 mm Hg at day 14 [P=0.004]. Rebleeding occurred in one [3.3%] patient on the 4[th] day post treatment. Comparison between the case group and the other two historical control groups with respect to the rebleeding rate demonstrated statistically significant differences between the case group and the first control group [P=0.008] but no statistically significant differences between the case group and the second control group [P=0.25]

Conclusion: Topical tranexamic acid seems promising in the management of traumatic hyphema. However, the small sample size of the present study precludes the conclusion that topical tranexamic acid can replace the oral tranexamic acid

Effect of Fas-670 A/G gene polymorphism on corneal allograft endothelial rejection

Human cornea expresses functional Fas-ligand capable of killing Fas+ activated lymphocytes. Fas expression is partly regulated by -670 A/G polymorphism in the promoter region of Fas gene. The aim of the present study is to determine the association between Fas-670A/G polymorphism and survival of corneal transplantation. In 276 graft recipients who mainly underwent penetrating keratoplasty because of keratoconus, bullous keratopathy and corneal opacity, Fas -670 A/G polymorphism was determined by allele specific oligonucleotide polymerase chain reaction [ASO-PCR] techniques. There was no statistically significant relationship between Fas -670 A/G polymorphism and rejection episode [p=0.35]. Moreover, the relationship between this polymorphism and rejection episode outcome [transplant recovery vs failure] was not statistically significant [p=0.13]. The results of the present study show no significant correlation between corneal graft rejection, rejection recovery and Fas -670A/G gene polymorphism

Amniotic membrane transplantation for primary pterygium surgery

To evaluate the outcomes of primary pterygium excision with adjunctive amniotic membrane transplantation. In an interventional case series, consecutive patients with primary pterygia underwent surgical excision with transplantation of preserved amniotic membrane onto bare sclera. Patients were followed for at least 12 months and the results were evaluated in terms of recurrent pterygium growth and complications. Fifty eyes of 50 consecutive patients including 27 male and 23 female subjects with mean age of 43.36 +/- 10.88 years were operated. The pterygia extended onto the corneas for 4.69 +/- 1.2 [range 3 to 7] mm. Only one eye [2%] demonstrated recurrent pterygium growth which responded to subconjunctival mitomycin C injection. Another eye [2%] developed amniotic membrane retraction which eventually required a second transplantation leading to complete resolution. Primary pterygium excision with amniotic membrane transplantation is a safe and effective surgical technique with low recurrence rate