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Related Experiment Videos

Tissue plasminogen activator for postvitrectomy fibrin formation.

G J Jaffe1, G W Abrams, G A Williams

  • 1Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.

Ophthalmology
|February 1, 1990
PubMed
Summary

Recombinant tissue plasminogen activator (tPA) effectively resolved severe intraocular fibrin after vitrectomy surgery in most patients. This treatment led to retinal reattachment and improved visual acuity in many cases with minimal complications.

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Area of Science:

  • Ophthalmology
  • Regenerative Medicine

Background:

  • Severe intraocular fibrin formation can occur post-vitrectomy, particularly in complicated cases like proliferative vitreoretinopathy (PVR), diabetic traction retinal detachment (TRD), and endophthalmitis.
  • This fibrin can impede surgical success and visual recovery, necessitating effective treatment strategies.

Purpose of the Study:

  • To evaluate the efficacy and safety of recombinant tissue plasminogen activator (tPA) for treating severe intraocular fibrin after vitrectomy.
  • To assess the impact of tPA treatment on retinal reattachment and visual acuity.

Main Methods:

  • Twenty-three eyes of 22 patients with post-vitrectomy fibrin formation received 25 micrograms of recombinant tPA injected into the anterior chamber or vitreous cavity.
  • Patients had underlying conditions including PVR, TRD, or endophthalmitis.

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  • Outcomes were assessed based on fibrinolysis, time to resolution, need for repeat injection, retinal attachment, visual acuity, and complications.

    • Main Results:

    • Complete fibrinolysis was achieved in 21 of 23 eyes (91%), with partial lysis in one eye.
    • The mean time to fibrin resolution was 3.0 +/- 1.0 hours.
    • Retinal reattachment was observed in 18 of 23 eyes (78%), and visual acuity improved in 12 eyes (52%).
    • Complications were generally mild and transient, including hyphema and corneal stromal thickening.

    Conclusions:

    • Intraocular injection of recombinant tPA is a highly effective treatment for severe fibrin formation following vitrectomy surgery.
    • tPA facilitates fibrinolysis, promotes retinal reattachment, and can lead to visual acuity improvement in patients with complex ocular conditions.
    • The treatment demonstrates a favorable safety profile with manageable complications.