Rebleeding in experimental traumatic hyphema treated with intraocular tissue plasminogen activator
D. F. Williams, D. P. Han and G. W. Abrams
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, 53226.
Tissue plasminogen activator has recently been shown to enhance the
clearance of experimental nontraumatic hyphema in animals. However, hyphema
in human eyes usually results from ocular trauma, and rebleeding is a
serious complication. Hemorrhage is also a potential complication of
fibrinolytic therapy. We assessed the incidence of rebleeding in an animal
model of surgically induced traumatic hyphema after intracameral injection
of tissue plasminogen activator (25 micrograms) or physiological saline.
Eight eyes were each treated with tissue plasminogen activator or
physiological saline at 10 minutes, 24 hours, 48 hours, or 72 hours after
injury. Controls were 8 eyes with hyphema but no intracameral injection. No
eyes treated with physiological saline (total, 32 eyes) or control eyes
rebled. In contrast, the incidence of rebleeding from the injury site in
eyes treated with tissue plasminogen activator was 88% (7/8) at 10 minutes,
75% (6/8) at 24 hours, 50% (4/8) at 48 hours, and 0% (0/8) at 72 hours
after injury. Treatment of traumatic hyphema with tissue plasminogen
activator prior to healing of damaged vascular endothelium may contribute
to rebleeding.
