Abstract：
Pilot studies suggest that waiting 15 minutes after a subcutaneous tranexamic acid injection is associated with decreased intraoperative bleeding and postoperative ecchymosis in eyelid surgery. The outcomes of commencing eyelid surgery immediately after injection without a waiting period remain unexplored.
This prospective, randomized, multicenter, double-masked, controlled study examined bilateral symmetric upper and/or lower lid blepharoplasty or ptosis repair. Patients received tranexamic acid in 1 eyelid and control in the contralateral eyelid. The surgeon recorded the side with more intraoperative bleeding. Two masked graders evaluated periocular ecchymosis at postoperative day 0 and postoperative week 1 (POW 1) with a 5-point scale. At POW 1, patients reported subjective grading of bruising as increased on 1 side or similar on both sides. Results were analyzed with Wilcoxon signed-rank and sign tests.
Of 130 patients, there was less eyelid ecchymosis on the tranexamic side at postoperative day 0 ( p = 0.001) and POW 1 ( p < 0.001). By surgery type, the 69 levator advancement surgeries had significantly less ecchymosis at postoperative day 0 ( p < 0.001) and POW 1 ( p = 0.001), while upper eyelid blepharoplasty, combined upper and lower lid blepharoplasty, and conjunctivomullerectomy trended toward significance. Of 68 patients reporting a POW 1 grading, 69% reported less bruising on the tranexamic side ( p < 0.001). Intraoperative bleeding was not significantly different between sides ( p = 0.930).
Without a postinjection waiting period, subcutaneous tranexamic acid for eyelid surgery significantly decreased postoperative ecchymosis on postoperative day 0 and POW 1 but did not affect intraoperative bleeding. Subcutaneous tranexamic acid was not associated with any complications.
This prospective, randomized, multicenter, double-masked, controlled study examined bilateral symmetric upper and/or lower lid blepharoplasty or ptosis repair. Patients received tranexamic acid in 1 eyelid and control in the contralateral eyelid. The surgeon recorded the side with more intraoperative bleeding. Two masked graders evaluated periocular ecchymosis at postoperative day 0 and postoperative week 1 (POW 1) with a 5-point scale. At POW 1, patients reported subjective grading of bruising as increased on 1 side or similar on both sides. Results were analyzed with Wilcoxon signed-rank and sign tests.
Of 130 patients, there was less eyelid ecchymosis on the tranexamic side at postoperative day 0 ( p = 0.001) and POW 1 ( p < 0.001). By surgery type, the 69 levator advancement surgeries had significantly less ecchymosis at postoperative day 0 ( p < 0.001) and POW 1 ( p = 0.001), while upper eyelid blepharoplasty, combined upper and lower lid blepharoplasty, and conjunctivomullerectomy trended toward significance. Of 68 patients reporting a POW 1 grading, 69% reported less bruising on the tranexamic side ( p < 0.001). Intraoperative bleeding was not significantly different between sides ( p = 0.930).
Without a postinjection waiting period, subcutaneous tranexamic acid for eyelid surgery significantly decreased postoperative ecchymosis on postoperative day 0 and POW 1 but did not affect intraoperative bleeding. Subcutaneous tranexamic acid was not associated with any complications.
摘要：
目的：初步研究表明，氨甲环酸皮下注射后等待15分钟与眼睑手术中出血和术后瘀斑减少有关。注射后立即开始眼睑手术而没有等待期的结果仍未被探索。
方法：这种前瞻性，随机化，多中心，双面蒙面,对照研究检查了双侧对称上眼睑和/或下眼睑成形术或上眼睑修复。患者在1个眼睑中接受氨甲环酸，在对侧眼睑中接受对照。外科医生记录了术中出血较多的一侧。两名蒙面分级者在术后第0天和术后第1周（POW1）以5分量表评估了眼周瘀斑。在POW1时，患者报告的瘀伤主观评分在一侧增加或两侧相似。结果用Wilcoxon符号秩和符号检验进行分析。
结果：在130名患者中，术后第0天（p=0.001）和POW1天（p<0.001），氨甲环侧眼睑瘀斑较少。按手术类型，69名上提肌前移手术在术后第0天(p<0.001)和POW1天(p=0.001)的瘀斑明显较少，而上眼睑成形术，上眼睑和下眼睑联合成形术，结膜切除术具有重要意义。在68例报告POW1分级的患者中，69%报告氨甲环侧的瘀伤较少(p<0.001)。术中出血在两侧之间没有显着差异（p=0.930）。
结论：没有注射后等待期，皮下氨甲环酸用于眼睑手术显著减少术后第0天和POW1天的术后瘀斑，但不影响术中出血。皮下氨甲环酸与任何并发症无关。
方法：这种前瞻性，随机化，多中心，双面蒙面,对照研究检查了双侧对称上眼睑和/或下眼睑成形术或上眼睑修复。患者在1个眼睑中接受氨甲环酸，在对侧眼睑中接受对照。外科医生记录了术中出血较多的一侧。两名蒙面分级者在术后第0天和术后第1周（POW1）以5分量表评估了眼周瘀斑。在POW1时，患者报告的瘀伤主观评分在一侧增加或两侧相似。结果用Wilcoxon符号秩和符号检验进行分析。
结果：在130名患者中，术后第0天（p=0.001）和POW1天（p<0.001），氨甲环侧眼睑瘀斑较少。按手术类型，69名上提肌前移手术在术后第0天(p<0.001)和POW1天(p=0.001)的瘀斑明显较少，而上眼睑成形术，上眼睑和下眼睑联合成形术，结膜切除术具有重要意义。在68例报告POW1分级的患者中，69%报告氨甲环侧的瘀伤较少(p<0.001)。术中出血在两侧之间没有显着差异（p=0.930）。
结论：没有注射后等待期，皮下氨甲环酸用于眼睑手术显著减少术后第0天和POW1天的术后瘀斑，但不影响术中出血。皮下氨甲环酸与任何并发症无关。
