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—We agree with Dr Mindel that there certainly are different concerns when using tranexamic acid for the treatment of hyphemas. Considering the complications associated with secondary hemorrhage, eg, optic atrophy, glaucoma, and corneal blood staining, treatment that significantly decreases the rate of secondary hemorrhage is clearly indicated.After receiving Dr Mindel's letter, we took the question of adverse reactions caused by tranexamic acid to the meeting of the Finnish Ophthalmological Society. Tranexamic acid has been used in almost all eye clinics in Finland for several years for the treatment of hyphemas. No one could identify any adverse reactions, and no one had seen any retinal degeneration that could be related to the use of tranexamic acid. This certainly is not a scientific proof, but it supports our own data. Our experience concerning the side effects of tranexamic acid was based on the 5-year prospective study in which 121
Uusitalo R, Tarkkanen A. Problems in the Use of Tranexamic Acid by Ophthalmologists-Reply. Arch Ophthalmol. 1989;107(4):487. doi:10.1001/archopht.1989.01070010500008