Therapeutic application of tissue plasminogen activator for fibrin reaction after cataract surgery.

PURPOSE: To evaluate the efficacy and safety of therapeutic application of recombinant tissue plasminogen activator (rtPA) for fibrin reaction after uneventful cataract surgery.

SETTING

Department of Ophthalmology, SSK Istanbul Hospital, Istanbul, Turkey.

METHOD: In a prospective study between January and June 2000, 26 eyes of 26 patients with fibrin reaction after uneventful cataract surgery received 3 microg of intracameral rtPA. Patients were evaluated for recurrences of fibrin reaction or complications by slitlamp biomicroscopy 2, 12, and 24 hours, 1 week, and 1 and 6 months after rtPA application. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. Visual acuity was tested using a standard Snellen chart 1 week after rtPA application.

RESULTS

All 26 eyes had complete fibrinolysis. Three eyes (11.5%) had corneal edema that lasted fewer than 24 hours. Visual acuity improved by 0 to 7 lines in 19 patients (73.1%). No patient had an increase in IOP. At 6 months, no patient had hyphema or recurrence of fibrin reaction.

CONCLUSIONS

Complete lysis of fibrin after cataract surgery with conventional topical medications can take a long time and is not successful in some patients. Intracameral application of 3 microg rtPA was an efficient, safe method for the treatment of fibrin reaction after cataract surgery.