Kimura M, Eguchi S, Araie M, Akahoshi T, Kohda F
Department of Ophthalmology, University of Tokyo School of Medicine, Bunkyo-ku, Japan.
Nippon Ganka Gakkai Zasshi. 1992 Oct;96(10):1240-7.
Effects of anticoagulant or fibrinolytic therapy on anterior chamber fibrin following cataract surgery was evaluated. In one series of experiment, various amounts of antithrombin III (ATIII), an anticoagulant, were injected into the anterior chamber of the rabbit eye immediately after phacoemulsification of the lens. In another series, various amounts of tissue plasminogen activator (TPA), a fibrinolytic agent, were injected into the anterior chamber 24 hours after phacoemulsification when it was filled with fibrin. The extent of the fibrin clot was graded using a slit lamp microscope, and the aqueous flare intensity was determined with a laser cell-flare meter for 2 weeks after operation. The eyes treated with TPA was also examined with light and electron microscopy. ATIII showed an inhibitory effect on fibrin formation, but complete inhibition was not obtained even with the highest concentration used. In contrast, the fibrin clot was completely resolved even with the lowest dose of TPA used, while no side effect such as inflammation or bleeding was seen. Histological examinations revealed no pathological changes in eyes treated with TPA. TPA may be a promising agent for fibrin resolution after cataract surgery.
评估了抗凝或纤溶疗法对白内障手术后前房纤维蛋白的影响。在一系列实验中,在晶状体超声乳化术后立即将不同量的抗凝剂抗凝血酶III(ATIII)注入兔眼前房。在另一系列实验中,当超声乳化术后24小时前房充满纤维蛋白时,将不同量的纤溶药物组织型纤溶酶原激活剂(TPA)注入前房。使用裂隙灯显微镜对纤维蛋白凝块的程度进行分级,并在术后2周用激光细胞闪光仪测定房水闪光强度。还用光学显微镜和电子显微镜检查了接受TPA治疗的眼睛。ATIII对纤维蛋白形成有抑制作用,但即使使用最高浓度也未获得完全抑制。相比之下,即使使用最低剂量的TPA,纤维蛋白凝块也完全溶解,同时未观察到炎症或出血等副作用。组织学检查显示接受TPA治疗的眼睛无病理变化。TPA可能是白内障手术后溶解纤维蛋白的一种有前景的药物。