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¹M.D., Beyoglu Training and Research Hospital, Eye Clinic, İstanbul/TURKEY
²M.D., Specialist Ophthalmologiest, İstanbul/TURKEY
³M.D. Asistant Professor, Baskent University Faculty of Medicine, Departmant of Ophthalmology, İstanbul/TURKEY
⁴M.D. Professor, Beyoglu Training and Research Hospital, Eye Clinic, İstanbul/TURKEY
⁵M.D. Associate Professor, Beyoglu Training and Research Hospital, Eye Clinic, İstanbul/TURKEY Purpose: To evaluate the efficiency of the use of intracameral tissue plasminogen activator (tPA) for severe anterior segment fibrin membrane formation following uneventful cataract surgery that fails to respond to maximum topical and systemic anti-inflammatory therapy.
Material and Methods: 0.1 cc of 25 μg/ml tPA was applied to the anterior chamber in 20 patients who had fibrin membrane formation following uneventful cataract surgery that failed to respond to maximal anti-inflammatory treatment. The intervention is done in the 8th to 30th postoperative days. The dissolution of fibrin membrane, visual acuity and intraocular pressures were assessed on 1., 2., 3. hours, 1., 2., 3., days and 1., 2., 3. weeks following the tPA injection.
Results: After intracameral tPA application, 12 cases out of 20 (60%) showed complete dissolution of the fibrin membrane. 6 cases (30%) had a partial improvement and these cases had complete resolution with additional anti-inflammatory therapy. 1 case (5%) showed no improvement while another case (5%) had complete resolution after a second tPA application. In 3 cases that had angle closure with pupillary block, intraocular pressure dropped to normal levels one day after tPA. Visual acuity improved in 12 cases (60%) on whom tPA was effective and in 1 additional case (5%) that had tPA re-application. In one case that was resistant to tPA, intraocular pressure following tPA had a transient increase that had responded to anti-glaucomatous therapy.
Conclusion: Low dose intracameral tPA is an effective and safe method for persistent fibrin membrane formation following cataract surgery. Keywords : tPA, fibrin membrane, cataract surgery