Koerner F, Boehnke M
Department of Ophthalmology, Bern University Hospital, Inselspital, Switzerland.
Ger J Ophthalmol. 1992;1(5):354-60.
In a preliminary clinical study, recombinant tissue plasminogen activator (rt-PA) was injected into the anterior chamber of 18 eyes and into the vitreous cavity of 2 eyes in a total of 20 patients. The clinical indications were severe fibrin formation after filtering operations for glaucoma (8 eyes), diabetic neovascular glaucoma (3), fibrin and hemorrhage after vitrectomy (3), keratoplasty (3), posterior chamber lens implantation (1), trauma (1), and endophthalmitis (1). Complete fibrinolysis within a minimum of 2 h was achieved in 81% of 26 injections. Although doses of about 12 micrograms rt-PA were generally given, in our observations, 6 micrograms proved to be sufficient for rapid fibrinolysis in selected cases. Injections of rt-PA should not be considered before the 3rd postoperative day so as to avoid rebleeding and recurrent fibrin formation. No toxic intraocular side effect was observed after the use of rt-PA in this study.
在一项初步临床研究中，共20例患者，将重组组织型纤溶酶原激活剂（rt-PA）注入18只眼的前房和2只眼的玻璃体腔。临床适应证包括青光眼滤过术后严重纤维蛋白形成（8只眼）、糖尿病新生血管性青光眼（3只眼）、玻璃体切除术后纤维蛋白和出血（3只眼）、角膜移植术（3只眼）、后房型人工晶状体植入术（1只眼）、外伤（1只眼）和眼内炎（1只眼）。26次注射中有81%在至少2小时内实现了完全纤维蛋白溶解。虽然一般给予约12微克rt-PA的剂量，但在我们的观察中，6微克被证明在某些病例中足以实现快速纤维蛋白溶解。rt-PA注射不应在术后第3天之前进行，以避免再次出血和纤维蛋白形成复发。本研究中使用rt-PA后未观察到眼内毒性副作用。
