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  • Title: Intracameral tissue plasminogen activator to treat severe fibrinous effusion after cataract surgery.
    Author: Wedrich A, Menapace R, Ries E, Polzer I.
    Journal: J Cataract Refract Surg; 1997; 23(6):873-7. PubMed ID: 9292671.
    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.
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