Intracameral tissue plasminogen activator to treat severe fibrinous effusion after cataract surgery.
OBJECTIVE
To evaluate the efficacy and complications of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous effusion after cataract and combined cataract and glaucoma surgery.


METHODS
University Eye Hospital Vienna, Austria.


METHODS
In a prospective study, 40 eyes of 39 patients with severe fibrinous anterior chamber reaction in the early postoperative course received 25 microg r-tPA intracamerally through a temporal paracentesis. The main outcome measures were rate of complete fibrinolysis, time of maximal effect, and complications.


RESULTS
Complete fibrinolysis occurred in 33 eyes (83%) after a mean of 3.2 hours +/- 0.9 (SD). The rate of complete fibrinolysis was higher in eyes having cataract surgery only (24 eyes, 89%) than in those having combined surgery (9 eyes, 69%). Recurrent fibrin was seen in 3 eyes (7%), small anterior chamber hemorrhage in 7 (18%), increased intraocular pressure in 3 (7%), and posterior synechias in 13 (33%). Complications were managed conservatively.


CONCLUSIONS
The intracameral injection of 25 microg r-tPA proved to be a safe, efficient, and low-risk supplement in the treatment of severe postoperative fibrinous reactions.
Wedrich
A
A
University Eye Hospital Vienna, Austria.
Menapace
R
R
Ries
E
E
Polzer
I
I
D000368:Aged; D000867:Anterior Chamber / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects*; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011994:Recombinant Proteins; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014130:Trabeculectomy / Q000009:adverse effects; D016896:Treatment Outcome
D011994:Recombinant Proteins; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator