[Vitreous hemorrhage after vitrectomy in diabetic retinopathy and tissue plasminogen activator].
OBJECTIVE
To determine if intraocular recombinant tissue plasminogen activator (r-TPA) can be used to treat fibrin blood clots (hyphemas/vitreous) after vitrectomy surgery for diabetic retinopathy.


METHODS
After a retrospective review of medical records, we found 52 patients who underwent vitrectomy for diabetic retinopathy and non-resolving vitreous hemorrhage and/or hyphema during the early postoperative (6 weeks). They were administered r-TPA in dose of 25 microgr/0.1 ml. Hyphemas and vitreous hemorrhages were classified in four grades.


RESULTS
Tissue Plasminogen Activator was used after vitrectomy surgery in 52 fibrin clotted eyes (52 patients), within the first 3 days post surgery. Vitreous hemorrhages were categorized as grade 2 (21%), grade 3 (67.3%) and grade 4 (11.5%). Hyphemas observed in 18 eyes presented grade 3 (38.9%) and grade 4 (61%). We saw no evidence of intraocular reactions against the r-TPA solution at the dose used in this study.


CONCLUSIONS
Fibrin blood clots can successfully and effectively be treated with intraocular r-TPA in doses of 25 microgr/0.1 ml (Arch Soc Esp Oftalmol 2002; 77: 7-12).
Asensio Sánchez
V M
VM
Hospital General del INSALUD, Medina del Campo, Valladolid, España.
Pérez Flández
F J
FJ
Carlos Bejarano
J
J
Fernández Concellón
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000150:complications*; D005130:Eye Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014821:Vitrectomy / Q000009:adverse effects*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator