Summary of findings 2. Topical aminocaproic acid compared with placebo for traumatic hyphema.

Topical aminocaproic acid compared with placebo for traumatic hyphema
Patient or population: people with traumatic hyphema Settings: hospital Intervention: 25% to 30% aminocaproic acid in gel every 6 hours Comparison: placebo
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	No. of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Placebo	Topical aminocaproic acid
Short‐term visual acuity 20/40 or better ≤ 2 weeks after treatment	481 per 1000	419 per 1000 (226 to 770)	RR 0.87 (0.47 to 1.60)	51 (1)	⊕⊕⊝⊝ low1	Outcome not reported by 1 other study.
Medium‐term visual acuity 20/40 or better > 2 weeks and ≤ 2 months after treatment	See comment	‐	‐	‐	‐	1 study reported no difference between groups after 2 weeks of follow‐up.
Long‐term visual acuity 20/40 or better > 2 months after treatment	See comment	‐	‐	‐	‐	Outcome not reported.
Final visual acuity 20/40 or better at resolution of hyphema	See comment	‐	‐	‐	‐	Outcome not reported.
Time to resolution of primary hemorrhage	See comment	‐	‐	142 (2)	⊕⊕⊝⊝ low2,3	In 1 study, average time to resolution of the hemorrhage was 11.1 days in participants receiving topical aminocaproic acid and 9.3 and 9.5 days in those receiving placebo; in the second study, the authors reported "no difference" in time to resolution between study groups.
Secondary hemorrhage at any time point	227 per 1000	109 per 1000 (45 to 250)	RR 0.48 (0.20 to 1.10)	131 (2)	⊕⊕⊝⊝ low3,4
Adverse effects: systemic hypotension	See comment	‐	‐	‐	‐	1 study reported that 13% of participants in the topical aminocaproic acid group versus 11% of participants in the placebo group had systemic hypotension.
*The basis for the assumed risk is the control group risk across studies. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.

¹Downgraded for imprecision (‐2).
 ²Downgraded for inconsistency (large variation in effect estimate across trials) (‐1).
 ³Downgraded for indirectness (outcome unrelated to visual acuity or possible complications) (‐1).
 ⁴Downgraded for imprecision (‐1).