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The use of tissue plasminogen activator in postvitrectomy cases
C Koutsandrea1, M Apostolopoulos, P Theodossiadis
1Athens University Eye Clinic, General Hospital of Athens, Greece.
International Ophthalmology
|April 1, 1993
Summary
Tissue plasminogen activator (tPA) effectively resolved anterior chamber fibrin formation after vitrectomy. However, tPA showed limited efficacy for vitreous hemorrhage and proliferative vitreoretinopathy complications.
Area of Science:
- Ophthalmology
- Vitreoretinal Surgery
Background:
- Post-vitrectomy complications, including fibrin formation and hemorrhage, can impact visual outcomes.
- Tissue plasminogen activator (tPA) is a fibrinolytic agent with potential applications in ophthalmic surgery.
Purpose of the Study:
- To evaluate the efficacy and safety of intraocular tissue plasminogen activator (tPA) injections in managing specific post-vitrectomy complications.
Main Methods:
- Seventeen eyes underwent vitrectomy followed by intraocular injection of 25 micrograms of tPA.
- Injections were administered into the anterior chamber (10 eyes) or vitreous cavity (7 eyes).
- Follow-up ranged from 4 to 15 months.
Main Results:
- Successful fibrinolysis was observed in all 10 cases with anterior chamber fibrin formation within 3-4 hours, with no recurrence.
- tPA was effective for perisilicone proliferation but ineffective for vitreous hemorrhage and fibrin/cellular proliferation on the iris.
- Complications were mild and transient.
Conclusions:
- Intraocular tPA is a safe and effective treatment for post-vitrectomy fibrin formation in the anterior chamber.
- tPA demonstrates limited utility in managing post-vitrectomy vitreous hemorrhage and certain forms of proliferative vitreoretinopathy.