Retinal cases & brief reports · 2025
Intraocular tissue plasminogen activator during vitrectomy in the management of acute severe bacterial endophthalmitis.
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Reding Monia A, Rao Prethy, Chang Emmanuel Y
Аннотация
PURPOSE: To describe a novel off-label use of tissue plasminogen activator (tPA) in the setting of severe endophthalmitis for improved surgical outcomes during pars plana vitrectomy.
METHODS: After a limited core vitrectomy is completed, 50mcg/0.1ml tPA is administered intravitreally and allowed to take effect with a 15-minute lights-out period. A fluid-fluid exchange is then carried out to lavage the inflammatory debris and tPA from the posterior segment.
RESULTS: This technique allows for significantly improved surgical visualization and complete removal of inflammatory debris in the anterior and posterior segment.
CONCLUSION: Increased clearance of intraocular inflammatory debris may reduce post-infection inflammatory sequalae such as posterior synechiae and preretinal membranes and achieve better surgical outcomes.
METHODS: After a limited core vitrectomy is completed, 50mcg/0.1ml tPA is administered intravitreally and allowed to take effect with a 15-minute lights-out period. A fluid-fluid exchange is then carried out to lavage the inflammatory debris and tPA from the posterior segment.
RESULTS: This technique allows for significantly improved surgical visualization and complete removal of inflammatory debris in the anterior and posterior segment.
CONCLUSION: Increased clearance of intraocular inflammatory debris may reduce post-infection inflammatory sequalae such as posterior synechiae and preretinal membranes and achieve better surgical outcomes.