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Introduction <p>TXA is garnering increasing attention for aesthetic periorbital procedures for its ability to reduce postoperative ecchymosis and bruising. The aim of this systematic review is to compile the current literature evidence on the effectiveness and safety of TXA in blepharoplasty.</p> Methods <p>Following PRISMA guidelines, this systematic review identified articles from PubMed, MEDLINE, Cochrane, and EMBASE databases up to October 4th, 2024, aiming to assess the efficacy of TXA in reducing bleeding and edema in patients undergoing blepharoplasty.</p> Results <p>Five studies were included, comprising a total of 604 patients who underwent blepharoplasty with TXA administration. TXA concentrations ranged from 50mg/mL to 100mg/mL locally, and 1g IV. Three studies reported a reduction in intra-operative bleeding with local TXA, with one study demonstrating statistical difference (<i>p</i> &lt; 0.001). Statistically significant reduction in time to achieve hemostasis with IV TXA (<i>p</i> &lt; 0.0001) and reductions in ecchymosis at 1 week postoperatively (<i>p</i> = 0.04) were reported. One study reported a statistically significant reduction in edema scores at 1 (<i>p</i> = 0.002) and 7 days (<i>p</i> = 0.01) postoperatively. Procedure times remained unchanged or reduced, with one study showing statistical significance with both IV (<i>p</i> = 0.003) and local (<i>p</i> = 0.03) TXA. None of the studies reported any infections or wound complications.</p> Conclusion <p>TXA administration appears to reduce intra-operative bleeding and postoperative ecchymosis and edema after blepharoplasty with no significant complications reported with IV and local administrations of TXA in the included studies. The development of standardized protocols for TXA administration highlighting the optimal dosage, timing, and administration routes is recommended.</p> Level of Evidence I <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors &#xa0;<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Evaluation of the Safety and Efficacy of Tranexamic Acid Use in Blepharoplasty: A Systematic Review of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2026年5月4日

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  • Rawan ElAbd,
  • Yasmina Richa,
  • Lucy Pu,
  • Taliah Hiyzajie,
  • Sinan Jabori,
  • Tyler Safran,
  • Mirko Gilardino

摘要

Introduction

TXA is garnering increasing attention for aesthetic periorbital procedures for its ability to reduce postoperative ecchymosis and bruising. The aim of this systematic review is to compile the current literature evidence on the effectiveness and safety of TXA in blepharoplasty.

Methods

Following PRISMA guidelines, this systematic review identified articles from PubMed, MEDLINE, Cochrane, and EMBASE databases up to October 4th, 2024, aiming to assess the efficacy of TXA in reducing bleeding and edema in patients undergoing blepharoplasty.

Results

Five studies were included, comprising a total of 604 patients who underwent blepharoplasty with TXA administration. TXA concentrations ranged from 50mg/mL to 100mg/mL locally, and 1g IV. Three studies reported a reduction in intra-operative bleeding with local TXA, with one study demonstrating statistical difference (p < 0.001). Statistically significant reduction in time to achieve hemostasis with IV TXA (p < 0.0001) and reductions in ecchymosis at 1 week postoperatively (p = 0.04) were reported. One study reported a statistically significant reduction in edema scores at 1 (p = 0.002) and 7 days (p = 0.01) postoperatively. Procedure times remained unchanged or reduced, with one study showing statistical significance with both IV (p = 0.003) and local (p = 0.03) TXA. None of the studies reported any infections or wound complications.

Conclusion

TXA administration appears to reduce intra-operative bleeding and postoperative ecchymosis and edema after blepharoplasty with no significant complications reported with IV and local administrations of TXA in the included studies. The development of standardized protocols for TXA administration highlighting the optimal dosage, timing, and administration routes is recommended.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.