To the Editor.
—Loewy and associates1 deserve congratulations for their fine laboratory study supporting, and suggesting avenues for refinement and improvement in, the administration of aminocaproic acid to prevent rebleeding in traumatic hyphema, a laudable and appropriate objective.In the "Comment" section, these authors discuss (bemoan?) the lack of acceptance of this drug by their colleagues because of the nature and high incidence of its side effects. They mention several potential routes to circumvent the problem of these systemic side effects, but each requires further research and time.I would like to suggest yet another way, currently available, to circumvent the side effects of aminocaproic acid: use systemic steroids instead.2 Systemic steroids (0.6 mg/kg/d for five days) have been and continue to be as good as aminocaproic acid.3 Perhaps long-term use of double-masked studies has blinded Loewy and his associates to this alternative.4-10
Romano PE. Systemic Steroids: An Alternative to Systemic Aminocaproic Acid to Prevent Rebleeding in Traumatic Hyphema. Arch Ophthalmol. 1987;105(5):610. doi:10.1001/archopht.1987.01060050028008