Wedrich A, Menapace R, Ries E, Polzer I
University Eye Hospital Vienna, Austria.
J Cataract Refract Surg. 1997 Jul-Aug;23(6):873-7. doi: 10.1016/s0886-3350(97)80246-5.
To evaluate the efficacy and complications of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous effusion after cataract and combined cataract and glaucoma surgery.
University Eye Hospital Vienna, Austria.
In a prospective study, 40 eyes of 39 patients with severe fibrinous anterior chamber reaction in the early postoperative course received 25 microg r-tPA intracamerally through a temporal paracentesis. The main outcome measures were rate of complete fibrinolysis, time of maximal effect, and complications.
Complete fibrinolysis occurred in 33 eyes (83%) after a mean of 3.2 hours +/- 0.9 (SD). The rate of complete fibrinolysis was higher in eyes having cataract surgery only (24 eyes, 89%) than in those having combined surgery (9 eyes, 69%). Recurrent fibrin was seen in 3 eyes (7%), small anterior chamber hemorrhage in 7 (18%), increased intraocular pressure in 3 (7%), and posterior synechias in 13 (33%). Complications were managed conservatively.
The intracameral injection of 25 microg r-tPA proved to be a safe, efficient, and low-risk supplement in the treatment of severe postoperative fibrinous reactions.
评估前房内注射重组组织型纤溶酶原激活剂（r-tPA）治疗白内障术后及白内障合并青光眼术后严重纤维蛋白渗出的疗效及并发症。
奥地利维也纳大学眼科医院。
在一项前瞻性研究中，39例患者术后早期出现严重纤维蛋白性前房反应的40只眼，通过颞侧穿刺前房内注射25微克r-tPA。主要观察指标为纤维蛋白完全溶解率、最大效应时间及并发症。
平均3.2小时±0.9（标准差）后，33只眼（83%）实现纤维蛋白完全溶解。单纯白内障手术眼（24只眼，89%）的纤维蛋白完全溶解率高于联合手术眼（9只眼，69%）。3只眼（7%）出现纤维蛋白复发，7只眼（18%）出现少量前房出血，3只眼（7%）眼压升高，13只眼（33%）出现虹膜后粘连。并发症采用保守治疗。
前房内注射25微克r-tPA被证明是治疗术后严重纤维蛋白反应的一种安全、有效且低风险的补充治疗方法。
