Treatment of total hyphemas with urokinase

Total hyphemas were created by aspirating the aqueous humor from the anterior chambers of rabbit eyes and then injecting human blood. Thirty-six of these eyes were then treated with urokinase. A control group of 26 eyes was treated with normal saline. Nine eyes with total hyphemas were left untreated. The untreated eyes had uniformly bad results with prolonged elevation of intraocular pressures, marked ciliary injection, and corneal vascularization. The normal saline control eyes cleared faster than the untreated eyes, probably because of the mechanical dissolution of the clot with irrigation or injection. However, these control eyes showed significantly poorer results than the enzyme-treated eyes. The eyes treated with urokinase, whether injected or irrigated, had a marked increase in the rate of absorption of clot and less fibrin formation in the anterior chamber. Intraocular pressures returned to normal much sooner in these eyes than in untreated eyes, and most corneas cleared completely.