Treatment of postvitrectomy fibrin formation with intraocular tissue plasminogen activator
G. A. Williams, F. H. Lambrou, G. A. Jaffe, R. W. Snyder, G. D. Green, R. G. Devenyi and G. W. Abrams
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee 53226.
Twenty-five micrograms of human recombinant tissue plasminogen activator
(tPA) was injected intracamerally into the eyes of three aphakic patients
who developed severe intraocular fibrin formation within 24 hours after
vitrectomy surgery. Fluid obtained from gas-fluid exchange specimens taken
24 hours after tPA injection was analyzed for tPA by an enzyme-linked
immunosorbent assay and a spectrophotometric solid-phase fibrin assay. In
each of the three patients, complete fibrin resolution occurred within four
hours after the tPA injection. There were no complications associated with
the intraocular tPA injections. There was measurable tPA activity 24 hours
after the initial injection ranging from 0.23 to 1.4 micrograms. In
contrast, tPA was undetectable in gas-fluid exchange specimens obtained
from seven patients who did not receive intraocular tPA injections.
Intraocular tPA is an effective means of treating postvitrectomy fibrin
formation in selected aphakic patients.
