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February 1984

Systemic Steroids or Aminocaproic Acid in the Management of Traumatic Hyphema?—Yes!

Author Affiliations

Gainesville, Fla

Arch Ophthalmol. 1984;102(2):189-192. doi:10.1001/archopht.1984.01040030143005

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To the Editor.  —Congratulations to McGetrick et al for their fine study on aminocaproic acid in traumatic hyphema.1 With widespread use of this drug or systemic steroids, hopefully one can eliminate the devastating effects and complications of rebleeding in traumatic hyphema. There is no question that one of these drugs must be used. The only question is which one?Aminocaproic acid caused substantial nausea and vomiting in 21.4% of patients receiving it,1 sufficient complication that the aminocaproic acid therapy had to be stopped in two patients. The authors recommend the routine use of antiemetic drugs along with aminocaproic acid. Certainly, the last thing one would wish for a patient with traumatic hyphema would be a bout of vomiting.The authors noted that 7.1% of the patients had diarrhea and 3.6% had muscle cramps, an overall complication rate of 32.1% attributed to aminocaproic acid.'As coauthor Goldberg2 noted

McGetrick JJ, Jampol LM, Goldberg MF, et al:  Aminocaproic acid decreases secondary hemorrhage after traumatic hyphema . Arch Ophthalmol 1983;101:1031-1033.Article
Goldberg MF:  Antifibrinolytic agents in the management of traumatic hyphema . Arch Ophthalmol 1983;101:1029-1030.Article
Yasuna E:  Management of traumatic hyphema . Arch Ophthalmol 1974;91:190-191.Article
Rynne MV, Romano P:  Systemic corticosteroids in the treatment of traumatic hyphema . J Pediatr Ophthalmol Strabismus 1980;17:141-143.
Romano P, Rynne MV:  Traumatic hyphema . Arch Ophthalmol 1981;99:2053.Article
Spoor TC, Hammer ME:  Traumatic hyphema . Arch Ophthalmol 1981;99:2053-2054.Article
Romano P:  Traumatic hyphema . Arch Ophthalmol 1981;99:2054.Article
Spoor TC, Hammer M, Belloso H:  Traumatic hyphema: Failure of steroids to alter its course: A double-blind prospective study . Arch Ophthalmol 1980;98:116-119.Article
Romano PE, Schuster G: Traumatic hyphema, in Fraunfelder FT (ed): Current Ocular Therapy, ed 2. Philadelphia, WB Saunders Co, 1982, in press.