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February 1984

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

Author Affiliations

Gainesville, Fla

Arch Ophthalmol. 1984;102(2):192. doi:10.1001/archopht.1984.01040030143006

In Reply.  —One of the major advances in clinical medicine in recent years has been the application of epidemiologic principles to the solution of pressing clinical problems. Major clinical trials have used these principles to avoid potential or actual biases in determining the efficacy of therapy for such problems as diabetic retinopathy,' macular degeneration,2 and sickle cell retinopathy.3 Prospective, randomized, controlled protocols with masked observations are important in such undertakings, and may give different results from more poorly constructed studies (compare the results of references 4 and 5 and references 6 and 7).Dr Romano believes that previous investigations have proved the value of systemic corticosteroids in reducing the rate of secondary hemorrhage following traumatic hyphema.6 Although these studies are of interest, the methodologies employed were deficient enough that we cannot agree. For example, the use of historic data, as well as data from patients of a

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