Williams D F, Han D P, Abrams G W
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, 53226.
Arch Ophthalmol. 1990 Feb;108(2):264-6. doi: 10.1001/archopht.1990.01070040116043.
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.
组织型纤溶酶原激活剂最近已被证明可增强动物实验性非创伤性前房积血的清除。然而，人类眼睛的前房积血通常由眼外伤引起，而再出血是一种严重的并发症。出血也是纤维蛋白溶解疗法的潜在并发症。我们评估了在手术诱导的外伤性前房积血动物模型中，前房内注射组织型纤溶酶原激活剂（25微克）或生理盐水后再出血的发生率。八只眼睛在受伤后10分钟、24小时、48小时或72小时分别接受组织型纤溶酶原激活剂或生理盐水治疗。对照组为8只患有前房积血但未进行前房内注射的眼睛。接受生理盐水治疗的眼睛（共32只）或对照眼均未再出血。相比之下，接受组织型纤溶酶原激活剂治疗的眼睛在受伤后10分钟时，损伤部位再出血的发生率为88%（7/8），24小时时为75%（6/8），48小时时为50%（4/8），72小时时为0%（0/8）。在受损血管内皮愈合之前用组织型纤溶酶原激活剂治疗外伤性前房积血可能会导致再出血。
