Intracameral tissue plasminogen activator to treat severe fibrinous effusion after cataract surgery

J Cataract Refract Surg. Jul-Aug 1997;23(6):873-7. doi: 10.1016/s0886-3350(97)80246-5.

Abstract

Purpose: To evaluate the efficacy and complications of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous effusion after cataract and combined cataract and glaucoma surgery.

Setting: University Eye Hospital Vienna, Austria.

Methods: In a prospective study, 40 eyes of 39 patients with severe fibrinous anterior chamber reaction in the early postoperative course received 25 microg r-tPA intracamerally through a temporal paracentesis. The main outcome measures were rate of complete fibrinolysis, time of maximal effect, and complications.

Results: Complete fibrinolysis occurred in 33 eyes (83%) after a mean of 3.2 hours +/- 0.9 (SD). The rate of complete fibrinolysis was higher in eyes having cataract surgery only (24 eyes, 89%) than in those having combined surgery (9 eyes, 69%). Recurrent fibrin was seen in 3 eyes (7%), small anterior chamber hemorrhage in 7 (18%), increased intraocular pressure in 3 (7%), and posterior synechias in 13 (33%). Complications were managed conservatively.

Conclusion: The intracameral injection of 25 microg r-tPA proved to be a safe, efficient, and low-risk supplement in the treatment of severe postoperative fibrinous reactions.

MeSH terms

  • Aged
  • Anterior Chamber / drug effects*
  • Anterior Chamber / pathology
  • Female
  • Fibrinolysis / drug effects*
  • Follow-Up Studies
  • Glaucoma / surgery
  • Humans
  • Lenses, Intraocular
  • Male
  • Phacoemulsification / adverse effects*
  • Plasminogen Activators / administration & dosage
  • Plasminogen Activators / therapeutic use*
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Recombinant Proteins
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use*
  • Trabeculectomy / adverse effects
  • Treatment Outcome

Substances

  • Recombinant Proteins
  • Plasminogen Activators
  • Tissue Plasminogen Activator