The Incidence of Complication and Decreased Visual Acuity in Traumatic Hyphema Patients According to the Amount of Blood Clot

ABSTRACT

We reviewed the medical records of 122 patients (122 eyes) who had been admitted for the traumatic hyphema at the Wallace memorial Baptist Hospital between January 1993 and June 1996, excluding perforating eye injury. And according to the degree of hyphema, the incidence of its complications such as early glaucoma, late glaucoma, rebleeding, or conreal staining , and decreased final visual acuity was analyzed. The degree of hyphema was graded by the amount of the anterior chamber filled with blood clot after layering of the red blood cells Grade I was defined as less than one third of anterior chamber, Grade II as one third to one half of it, Grade III as one half to nearly total of it, or Grade IV as total of it. The early or late glaucoma was defined as intraocular pressure using Goldmann` s applanation tonometer of 21mmHg or more on admission or at about 1 month after admission. The decreased final visual acuity is defined as final corrected visual acuity using Hans chart of 0.5 or less. Of 122 eyes, there were 92 eyes(75.4%) in Grade I, 20 eyes(16.4%) in Grade II, 6 eyes(4.9%) in Grade III, or 4 eyes(12.3%) in Grade IV. According to the grade, the incidence of early glaucoma was 10.9%(10 eyes) in Grade I, 25.0%(5 eyes) in Grade II, 16.7%(1 eye) in Grade III, or 25.0%(1eye) in Grade IV; that of late glaucoma was 3.3%(3eyes) in Grade I, 5.0%(1 eye) in Grade II, zero in Grade III, or 25%(1 eye) in Grade IV; that of rebleeding was zero in Grade I, 10.0%(2 eyes) in Grade II, 50.0%(3 eyes) in Grade III, or 50.0%(2 eyes) in Grade IV; that of conreal staining was 50.0%(2 eyes) in Grade IV but zero in Grade I, Grade II or Grade III; and that of decreased final visual acuity was 8.7%(8 eyes) in Grade I, 20.0%(4 eyes) in Grade II, 33.3%(2 eyes) in Grade III or 25%(1 eye) in Grade IV. The higher the grade, the higher the incidence of its complication and decreased final visual acuity not showing the statistical significance (P>0.05). However, the incidence of rebleeding and decreased final visual acuity was higher in Grade II to IV groups showing the statistical significance in comparison with Grade I(P<0.01). Therefore, it is considered that diagnosis, treatment , and follow-up should be made correctly and attentively in Grade II to IV groups than in Grade I.