Use of tissue plasminogen activator in experimental hyphema

Tissue plasminogen activator (tPA) is a fibrin-specific fibrinolytic agent that has recently been shown to be effective in accelerating the clearance of fibrin clots from the rabbit anterior chamber. We studied the effect of intracameral tPA on the clearance of experimental hyphema in the rabbit. Fifteen eyes were treated with an intracameral injection of tPA (1800 IU), 11 eyes were treated with a physiologic saline solution (PS) injection, and 16 eyes received no injection. Total hyphemas treated with tPA showed 80% clearance within 24 hours, while eyes treated with PS and untreated eyes cleared in 14 days. Measurement of corneal thickness revealed the tPA-treated eyes to have less corneal edema than eyes treated with PS and untreated eyes. There was no difference in intraocular pressure. The results indicate that tPA is effective in accelerating the clearance of experimental hyphema.