ABSTRACT
Purpose: to evaluate the effect of tranexamic acid on early postvitrectomy hemorrhage in diabetic patients
Methods: in a randomized double masked clinical trial, 62 diabetic patients scheduled for vitrectomy were randomly assigned to two groups. The treatment group [32 eyes] received two doses of tranexamic acid [10 mg/kg] shortly before and after the operation, intravenously and then orally for 4 days [20 mg/kg/8h]. Doses were adjusted according to serum creatinine level. The control group [30 eyes] received no medication. Both media clarity and visual acuity were compared during four weeks of follow up
Results: four weeks after treatment, visual acuity was low [/=20/200] in 64.3% of the treatment group. Corresponding figures in the control group were 26.1%, 26.1%, and 47.8%, respectively. These differences were not statistically significant. The ratio of mild to severe vitreous hemorrhage during the first four days and after four weeks was 79% to 21% and 82% to 18% in the treatment group and 76.7% to 23.3% and 78.3% to 21.7% in the control group respectively, which showed no significant difference. No important side effect of the drug was observed in this study. The only notable finding was a positive correlation between fresh preoperative vitreous hemorrhage and postoperative bleeding
Conclusions: tranexamic acid, with the dosage and method of administration in this study, has no effect on reducing early postvitrectomy hemorrhage in patients with proliferative diabetic retinopathy