Inhibition of intraocular fibrin formation after infusion of low-molecular-weight heparin during combined phacoemulsification-trabeculectomy surgery.
OBJECTIVE
To evaluate the effect of intraocular infusion of dalteparin, a low-molecular-weight heparin (LMWH) administered in the infusion fluid to prevent early postoperative fibrin formation in combined phacoemulsification-trabeculectomy surgery (phacotrabeculectomy).


METHODS
Farabi Eye Hospital, Tehran, Iran.


METHODS
Standard combined phacotrabeculectomy was performed prospectively in a masked fashion in 60 eyes; 35 eyes received 5 IU/mL LMWH in the infusate and 25 eyes served as controls. Masked postoperative examinations assessed visual acuity, intraocular pressure (IOP), anterior chamber cell and flare, and fibrin formation with slitlamp examinations 1, 3, 7, 30, and 90 days after surgery.


RESULTS
The rate of intraocular fibrin/membrane formation was significantly lower in the LMWH group than in the control group at each follow-up (P<.001, Student t test) . The amount of IOP was lower in LMWH group at each follow up (P<.01, Student t test). Final visual acuity was better in LMWH group (P = .03, Student t test). The frequency of synechia formation was lower in the LMWH group on day 90 (P = .002, chi-square test).


CONCLUSIONS
Infusion of dalteparin, a LMWH, may be an effective inhibitor of postoperative fibrin formation in phacotrabeculectomy surgery. It may reduce the frequency of synechia formation and improve visual acuity. It may not be associated with increased risk for intraoperative or postoperative complications at the tested dose. This drug may be a useful adjunct in combined surgery.
Zarei
Reza
R
Farabi Eye Research Center, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
Azimi
Reza
R
Moghimi
Sasan
S
Abdollahi
Ali
A
Amini
Heidar
H
Eslami
Yadollah
Y
Fakhraii
Ghasem
G
D000368:Aged; D002386:Cataract / Q000150:complications / Q000628:therapy; D017985:Dalteparin / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005337:Fibrin / Q000037:antagonists & inhibitors*; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005901:Glaucoma / Q000150:complications / Q000601:surgery; D006801:Humans; D007263:Infusions, Parenteral; D007429:Intraocular Pressure; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
D005343:Fibrinolytic Agents; D005337:Fibrin; D017985:Dalteparin