TREATMENT AND PROGNOSIS IN THE TRAUMATIC HYPHEMA

In our study, we evaluated treatment of traumatic hyphema and prognostic factors in visual outcomes. Between the years of 1992-1995, 100 traumatic hyphema patients which have been treated in outpatient or inpatient, have been included in this study. In 16 of 100 patients, in addition to medical therapy, surgical management was aso applied. Surgical management was paracentesis with anterior chamber washout and clot extraction. At the same session, anterior vitrectomy in one patients and lens aspiration in one patients were applied. Indications for surgical management were uncontrolled elevated intraocular pressure, corneal bloodstaining and prolonged clot. Final vision was worse than 1/10 in eight patients. All of those eight patients initially had total hyphema. Causes of reduced final vision were cataract, retinal detachment, optic atrophy, macular hole, corneal blood staining and phtisis bulbi. In conclusion, while complications of traumatic hyphema can be prevented with medical and surgical treatment, anterior and posterior segment problems determine visual prognosis.

TRAVMATÝK HÝFEMADA TEDAVÝ VE PROGNOZ

Çalýþmamýzda, travma ile oluþan hifemada tedavi yaklaþýmý ve sonuç görmeye etkili faktörler araþtýrýldý. 1992-1995 yýllarý arasýnda, ayaktan ve yatýrýlarak tedavisi yapýlan 100 travmatik hifema olgusu çalýþmaya alýndý. 16 olguya týbbi tedavinin yanýsýra cerrahi tedavi de uygulandý. Cerrahi giriþim olarak parasentez, ön kamara lavajý ve pýhtý çýkarýmý yapýlýrken, ek olarak ayný seansta 1 olguya ön vitrektomi, 1 olguya ise lens aspirasyonu yapýldý. Cerrahi giriþim endikasyonlarý kontrol altýna alýnamayan göz içi basýnç artýþý, disk hematik geliþimi ve gerilemeyen hifema idi. Sonuç görmesi 0.1'in altýnda olan olgu sayýsý 8 olup, tümü baþlangýçta grade 4 hifemaya sahipti. Az görme sebepleri; katarakt, retina dekolmaný, optik atrofi, makula deliði, disk hematik ve'ftizis bulbi idi. Sonuç olarak; travmatik hifemaya baðlý komplikasyonlar týbbi ve carrahi tedavi ile önlenebilirken, görme prognozunu hifemaya eþlik edebilen ön ve arka segment patolojileri belirlemektedir.