Szymanski A
Silesian School of Medicine, Department of Ophthalmology, Katowice, Poland.
Int Ophthalmol. 1992 Sep;16(4-5):387-90. doi: 10.1007/BF00917997.
Since 1987 we have performed, with good results, glaucoma filtering surgery in which the limbo-scleral fistula was closed by an autogenic full blood clot (sclerectomy under a clot). In 8 patients with advanced stages of glaucoma simplex, 1-3 days after sclerectomy under a clot with rise IOP, 25 micrograms of tissue plasminogen activator (tPA) was injected subconjunctivally. Two weeks after surgery normalization of IOP below 15 mmHg and normal outflow facility in all tPA treated eyes were obtained. No increase in early post-operative complications, such as hemorrhage or corneal haze, was attributable to tPA use. In early period after sclerectomy under a clot, when blockage of outflow appears, the use of tPA can cause the re-creation of filtering tract.
自1987年以来，我们开展了青光眼滤过手术，效果良好，该手术通过自体全血凝块封闭角膜缘-巩膜瘘（血凝块下巩膜切除术）。在8例晚期原发性青光眼患者中，血凝块下巩膜切除术后1至3天，眼压升高，结膜下注射25微克组织型纤溶酶原激活剂（tPA）。术后两周，所有接受tPA治疗的眼睛眼压均恢复正常，低于15 mmHg，房水流畅系数正常。未发现因使用tPA导致术后早期并发症（如出血或角膜混浊）增加。在血凝块下巩膜切除术后早期，当出现房水流出受阻时，使用tPA可促使滤过通道重新形成。
