Intraocular recombinant tissue-plasminogen activator fibrinolysis of fibrin formation after cataract surgery in children

J Cataract Refract Surg. 1999 Mar;25(3):357-62. doi: 10.1016/s0886-3350(99)80083-2.

Abstract

Purpose: To evaluate the efficacy and safety of intracameral recombinant tissue plasminogen activator (rt-PA) application for fibrinolysis of fibrin formation after cataract surgery in children.

Setting: Johann Wolfgang Goethe-University, Department of Ophthalmology, Frankfurt am Main, Germany.

Methods: This study comprised 11 eyes of 10 patients aged 3 to 13 years (mean 7.2 +/- 3.68 [SD]) who developed severe fibrin formation after cataract surgery and IOL implantation despite intensive topical steroid therapy. Under general anesthesia, fibrinolysis was performed with 10 micrograms of rt-PA 7.18 +/- 2.04 days after intraocular surgery. Follow-up included slitlamp examination, tonometry, visual acuity testing, and-ophthalmoscopy. Anterior chamber flare measurements could be performed in 6 eyes.

Results: Complete resolution of fibrin formations occurred in 90% of the patients in these cases, no recurrent fibrinous reaction or adverse effects were noted. In 2 eyes of the same patient with a history of juvenile rheumatoid arthritis and chronic uveitis, fibrin clot dissolution was incomplete. A recurrent fibrinous formation could be observed after 2 and 4 weeks, respectively. A beginning band keratopathy excluding the central and limbal cornea was noted after 6 and 8 weeks, respectively.

Conclusion: Intraocular application of rt-PA appears to be a safe and efficacious therapeutic approach in the management of severe fibrinous reactions after pediatric cataract surgery.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Anterior Chamber
  • Cataract Extraction* / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Fibrin / drug effects*
  • Fibrinolysis / drug effects*
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Pilot Projects
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / pathology
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use
  • Safety
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use*
  • Treatment Outcome
  • Visual Acuity

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Fibrin
  • Tissue Plasminogen Activator