Paracentesis as Surgical Intervention in Traumatic Hyphaema: Opinions and Practices of Nigerian Ophthalmologists

Abstract

Introduction: Various aspects of management of traumatic hyphaema are enmeshed in controversy. Surgery is done to prevent complications: optic atrophy and corneal blood staining occurring if a high risk exists of either or both occurring. Circumstances considered high risk do not enjoy universal consensus. Objectives: To determine what Nigerian ophthalmologists consider absolute indications for surgical intervention by means of anterior chamber paracentesis and hyphaema washout in closed globe traumatic hyphaema, evaluate these absolute indications, and attempt to evolve a guideline for surgical intervention based on areas of consensus and disagreement. Method: A semi-structured, pre-tested questionnaire with responses analyzed with SPSS 11 software. Result: Near universal agreement on indication exist on early corneal blood staining and sickle cell haemoglobinopathy. Differing views concern blackball, volume and duration of hyphaema and secondary hypertension-associated hyphaema. However, it appears surgery is embarked on earlier than other practitioners elsewhere may consider necessary. Conclusion: Risk level for non-surgical management against risk and benefit of surgery should be evaluated for each individual before surgery.