A study published in the European Journal of Ophthalmology has shown that tranexamic acid, a drug used to control bleeding, can be effectively delivered directly to the eye through topical eye drops. This finding presents a promising alternative to systemic (oral) administration for treating conditions like traumatic hyphema (bleeding in the front chamber of the eye), potentially reducing side effects and improving patient outcomes.

The primary goal in managing traumatic hyphema is to prevent secondary bleeding (rebleeding), which can lead to serious complications such as vision loss. While oral tranexamic acid is effective, it can cause systemic side effects like nausea and hypotension. This study investigated whether administering the drug as an eye drop could deliver a sufficient dose directly to the target area without these adverse effects.

Key Findings from the Study:

The research involved 47 patients scheduled for cataract surgery who received tranexamic acid eye drops prior to their procedure. Aqueous humor samples were then collected and analyzed.

• Effective Drug Concentration: A single 5% tranexamic acid eye drop achieved aqueous concentrations higher than 1.5 µg/mL for up to 160 minutes, eventually stabilizing at approximately 1.0 µg/mL for up to nine hours. This level is considered sufficient to inhibit fibrinolysis and prevent rebleeding.

• Higher Potency Option: In two patients who received a 10% solution, the aqueous concentration was 82% higher than the 5% solution after 60 minutes, demonstrating that dosage can be increased if needed.

• Faster Than Oral Route: The peak concentration from the eye drops was achieved in about two hours, which is faster than the three hours required for oral administration.

• Excellent Safety Profile: No significant ocular or systemic side effects were detected in any of the patients during the study or in follow-up visits.

Conclusion:

Topical administration of tranexamic acid is a safe and effective method for delivering therapeutic concentrations of the drug into the eye's anterior chamber. This localized approach offers a viable path for clinical trials to compare its efficacy against the oral route in preventing rebleeding in patients with traumatic hyphema, with the potential for better patient compliance and fewer side effects.

Source & Link to Original Article:

For credibility and academic integrity, the original research paper is cited below. You can access the full article via the following link.

• Citation: Hosseini, H. R. J., Montaseri, H., Khalili, M. R., & Simakani, S. A. (2009). Aqueous concentration of tranexamic acid after 5% and 10% eyedrop administration. European Journal of Ophthalmology, 19(4), 661–666.

• Link: https://journals.sagepub.com/doi/10.1177/112067210901900423