Tissue plasminogen activator treatment of postoperative intraocular fibrin

Intraocular recombinant tissue-type plasminogen activator was used for treatment of postoperative intraocular fibrin clots. Using a rabbit vitrectomy and cyclocryotherapy model of postoperative fibrin, rabbits were randomized on the first postoperative day to receive either an anterior chamber injection of lactated Ringer's solution or 25,000, 50,000, or 100,000 IU tissue plasminogen activator (tPA). An intraocular dose of 25,000 IU of tPA produced marked resolution of the fibrin clot 24 hours later. A 50,000 and 100,000 IU dose produced slightly more resolution of the fibrin. No ophthalmoscopic or histologic evidence of intraocular toxicity was seen.