Low-dose tissue plasminogen activator in the management of anterior chamber fibrin formation.
OBJECTIVE
To investigate the efficacy of tissue plasminogen activator (tPA) in the treatment of severe fibrinous anterior chamber reactions after intraocular surgery.


METHODS
Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece.


METHODS
The study comprised routine surgical and postoperative cases selected in a nonrandomized fashion. Low-dose tPA infusion (0.2 mL of 125 microg/mL) was administered through a side-port in the anterior chamber in 25 patients with recent or long-standing fibrin formation after cataract extraction (n = 13), trabeculectomy (n = 5), combined procedure (n = 5), or penetrating keratoplasty (n = 2). Patients were treated 4 to 25 days postoperatively (mean 7 days).


RESULTS
Fibrin lysis was observed 2 to 12 hours after tPA infusion. No hemorrhage or other complications occurred, and no further treatment was necessary in any patient. Three cases of delayed partial fibrin lysis resolved with intense topical steroid treatment. There were no recurrences over the 3-month follow-up.


CONCLUSIONS
Low-dose tPA was an effective and safe method for the management of anterior chamber fibrin formation. Treatment was well tolerated and gave excellent results with no complications.
Georgiadis
Nick
N
Ophthalmology Department, AHEPA University Hospital, Thessaloniki, Greece.
Boboridis
Kostas
K
Halvatzis
Nick
N
Ziakas
Nicolas
N
Moschou
Vagia
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects*; D002386:Cataract / Q000150:complications / Q000628:therapy; D005260:Female; D005337:Fibrin / Q000187:drug effects*; D005342:Fibrinolysis / Q000187:drug effects*; D005901:Glaucoma / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects; D010960:Plasminogen Activators / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000188:drug therapy; D012449:Safety; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014130:Trabeculectomy / Q000009:adverse effects
D005337:Fibrin; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator