Wedrich A, Menapace R, Mühlbauer-Ries E
University Eye Hospital Vienna, Austria.
Int Ophthalmol. 1994;18(5):277-80. doi: 10.1007/BF00917830.
In a prospective study performed between June 1992 and March 1994 19 eyes of 19 patients with dense fibrinous pupillary membranes following cataract surgery were treated with intracameral injections of 25 micrograms recombinant tissue plasminogen activator (r-tPA). Injections were performed between the second and twenty-third postoperative day (mean 5.6 +/- 6.9 days). Complete fibrinolysis within one to 4 hours (mean: 3.3 +/- 0.89 hours) was observed in 18 (94.7%) eyes. In one (5.3%) eye fibrinolysis was incomplete despite a second injection. In 2 (10.5%) eyes. No recurrence of a distinct fibrinous membrane was noted which then cleared spontaneously with topical treatment. A small hyphema developed in 2 (10.5%) eyes and intraocular pressure exceeded 25 mmHg in 2 (10.5%) eyes. No increase of keratopathy nor any toxic intraocular side effect of 25 micrograms intracameral r-tPA was observed throughout the study. The intracameral injection of r-tPA clinically proved to safely accelerate the resorption of dense fibrinous membranes following cataract surgery and thus enhance visual recovery minimizing subsequent complications and systemic or subconjunctival anti-inflammatory treatment.
在1992年6月至1994年3月进行的一项前瞻性研究中，对19例白内障手术后出现致密纤维蛋白性瞳孔膜的患者的19只眼睛进行了前房内注射25微克重组组织型纤溶酶原激活剂（r-tPA）的治疗。注射在术后第二天至第二十三天之间进行（平均5.6±6.9天）。18只（94.7%）眼睛在1至4小时内（平均：3.3±0.89小时）实现了完全纤维蛋白溶解。1只（5.3%）眼睛尽管进行了第二次注射，纤维蛋白溶解仍不完全。2只（10.5%）眼睛未观察到明显的纤维蛋白膜复发，随后经局部治疗自行消退。2只（10.5%）眼睛出现了少量前房积血，2只（10.5%）眼睛的眼压超过了25 mmHg。在整个研究过程中，未观察到角膜病变增加，也未观察到25微克前房内r-tPA有任何毒性眼内副作用。前房内注射r-tPA经临床证明可安全加速白内障手术后致密纤维蛋白膜的吸收，从而促进视力恢复，将后续并发症以及全身或结膜下抗炎治疗降至最低。
