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Tissue plasminogen activator and glaucoma drainage implants.
P A Sidoti1, E N Morinelli, D K Heuer
1Department of Ophthaimology, University of Southern California School of Medicine, and the Doheny Eye Institute, Los Angeles, California, U.S.A.
Journal of Glaucoma
|November 19, 2009
Summary
Tissue plasminogen activator effectively resolves glaucoma drainage tube obstruction caused by blood or fibrin clots. This treatment offers a less invasive alternative to surgery for managing elevated intraocular pressure post-glaucoma surgery.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Surgical Innovation
Background:
- Glaucoma drainage implants are crucial for managing intraocular pressure.
- Implant tube occlusion by blood or fibrin clots is a common postoperative complication.
- Neovascular glaucoma presents unique challenges for drainage device patency.
Purpose of the Study:
- To describe the use of tissue plasminogen activator for glaucoma drainage tube obstruction.
- To evaluate the efficacy of intracameral tissue plasminogen activator in resolving tube blockages.
- To present a less invasive management option for early postoperative complications.
Main Methods:
- Case report of two patients with neovascular glaucoma and drainage tube obstruction.
- Treatment involved intracameral injection of tissue plasminogen activator.
- Observation of intraocular pressure, bleb formation, and tube patency.
Main Results:
- Successful resolution of tube obstruction in both reported cases.
- Spontaneous reduction of intraocular pressure following treatment.
- Facilitation of bleb formation post-obstruction resolution.
Conclusions:
- Intracameral tissue plasminogen activator can effectively treat glaucoma drainage tube obstruction.
- This method is beneficial even when clots are not overtly visible.
- Consider tissue plasminogen activator before resorting to more invasive surgical revisions.
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