[Risk factors, prevention and therapy of fibrin reactions after IOL implantation].
BACKGROUND
Postoperative fibrinous reactions following the small-incision technique seem to be very rare. Problem cases can be treated with tissue Plasmin Activator.


METHODS
To investigate the new prophylactic and therapeutic possibilities the last 2,056 cataract procedures with PMMA lens implantation were statistically analyzed.


RESULTS
In 152 (7.4%) fibrin cases we observed after ECCE (n = 586) 12.8%, after phacoemulsification (PE) with sutured 6.5-mm corneoscleral incision (n = 546) 7.0% and after PE with clear corneal selfsealing 4.1-mm incision (n = 924) only 3.9% fibrinous reactions (p < 0.01). In case of ECCE the rate of fibrinous reactions amounted to 22.4% following prolonged procedures (< 50 min), while it was low as 9.5% with a short period of time (< 30 min) (p < 0.01). In 8 steroid-resistant cases we applied 25 micrograms Plasmin Activator intraocularly. The injections led to complete dissolution of the fibrinous membranes without complications.


CONCLUSIONS
Postoperative fibrinous reactions can be reduced statistically significantly by application of the corneal small-incision technique. The most efficient therapy is intraocular Plasmin Activator fibrinolysis.
Müller-Jensen
K
K
Augenklinik des Städtischen Klinikums Karlsruhe.
Zimmermann
H
H
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005337:Fibrin; D005342:Fibrinolysis / Q000187:drug effects; D005549:Foreign-Body Reaction / Q000628:therapy*; D006801:Humans; D007267:Injections; D007910:Lenses, Intraocular; D008297:Male; D008768:Methylmethacrylates; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D008768:Methylmethacrylates; D005337:Fibrin; D010959:Tissue Plasminogen Activator