[The use of tissue plasminogen activator in the post-operative treatment of fibrinoid uveitis].
OBJECTIVE
To evaluate the efficacy and safety of tissue plasminogen activator in management of postoperative fibrinous uveitis.


METHODS
Prospective study, interventional case series including 13 patients who developed fibrinous membrane in anterior chamber; patients were operated for cataract (4 cases), for cataract and glaucoma (7 cases) and for corneoscleral lacerations (2 cases). Initial treatment consisted of corticosteroid administration (topically, subconjunctival +/- systemic) and mydriatic-cycloplegic drugs. Inadequate response imposed intracavitary administration of tissue plasminogen activator (25 microg/ml, 0.2 ml). The main outcomes were: complete resolution of fibrinous membrane, presence of adverse events and visual rehabilitation.


RESULTS
Fibrinous membrane resorption starts in the next hours and complete resolution was proved in all cases after a mean time 53.55 +/- 37.65 (24-146) hours. In 12 patients we used only one administration of tissue plasminogen activator, but in one case we repeated it. It was not signaled any adverse event drug related. It was an important increase of visual acuity in all cases.


CONCLUSIONS
Intracavitary administration of tissue plasminogen activator is a safe and efficient alternative in the management of postoperative fibrinous membrane.
Chiseliţă
Dorin
D
Spitalul Clinic Universitar "SF. Spiridon", Iaşi.
Antohi
Ingrid
I
Cionca
Daniela
D
Medvichi
Radu
R
Cimpoeşu
Diana
D
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002387:Cataract Extraction / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005128:Eye Diseases / Q000601:surgery; D005260:Female; D005337:Fibrin / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014605:Uveitis / Q000188:drug therapy* / Q000473:pathology; D014792:Visual Acuity
D000305:Adrenal Cortex Hormones; D005343:Fibrinolytic Agents; D005337:Fibrin; D010959:Tissue Plasminogen Activator