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I commend Crouch et al¹ on their study, which was published in the September 1997 issue of the ARCHIVES. As the coordinator of a prospective, randomized study that supported the use of aminocaproic acid in the treatment of traumatic hyphema,² I have been disappointed when ophthalmologists were reluctant to use the drug because of the fear of potential side effects. With this demonstration of the efficacy of topical aminocaproic acid, more physicians may be willing to use it for their patients. However, I have several concerns with the article by Crouch et al.

Preliminary studies used aminocaproic acid ointment in the rabbit model.³ This model may not be comparable with the human eye. In the rabbit, there is an active transport mechanism for lysine; the concentration of lysine in the aqueous humor is twice the concentration found in the plasma.⁴ In contrast, in the human eye, the concentration of lysine . . . [Full Text of this Article]