TY - JOUR
T1 - Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery
AU - Osaadon, Perach
AU - Belfair, Nadav
AU - Lavy, Itay
AU - Walter, Eyal
AU - Levy, Jaime
AU - Tuuminen, Raimo
AU - Achiron, Asaf
AU - Knyazer, Boris
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2022/1
Y1 - 2022/1
N2 - Background: To describe the use of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous reactions in toxic anterior segment syndrome (TASS) after cataract surgery. Methods: A case series of 59 eyes of 59 patients with severe fibrinous anterior chamber reaction following cataract surgery who received intracameral r-tPA (25 µg/0.1 ml). The main outcome measures after intracameral r-tPA were the incidence of complete fibrinolysis, time of maximal effect, visual acuity, and complications. Results: Severe fibrinous reactions appeared 11.5 ± 5.3 days after cataract surgery. Fibrinolysis was observed 2.33 ± 2.70 days after rtPA use and 36 eyes (61%) exhibited resolution of the fibrin by the end of the first day following injection (p < 0.001). Transient corneal edema observed at 1-day after injection was the only complication reported during the injection of r-tPA or at follow-up. Eight eyes (13.6%) required a second r-tPA injection. Best-corrected visual acuity improved from 0.88 ± 0.67 logMAR units before rtPA injection to 0.48 ± 0.49 logMAR units at 1-month (p < 0.001). Conclusions: The application of r-tPA was a quick and efficacious therapeutic approach for the management of severe fibrinous reactions in TASS after cataract surgery. In a clinical setting, intracameral r-tPA may be useful when rapid visual recovery is needed.
AB - Background: To describe the use of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous reactions in toxic anterior segment syndrome (TASS) after cataract surgery. Methods: A case series of 59 eyes of 59 patients with severe fibrinous anterior chamber reaction following cataract surgery who received intracameral r-tPA (25 µg/0.1 ml). The main outcome measures after intracameral r-tPA were the incidence of complete fibrinolysis, time of maximal effect, visual acuity, and complications. Results: Severe fibrinous reactions appeared 11.5 ± 5.3 days after cataract surgery. Fibrinolysis was observed 2.33 ± 2.70 days after rtPA use and 36 eyes (61%) exhibited resolution of the fibrin by the end of the first day following injection (p < 0.001). Transient corneal edema observed at 1-day after injection was the only complication reported during the injection of r-tPA or at follow-up. Eight eyes (13.6%) required a second r-tPA injection. Best-corrected visual acuity improved from 0.88 ± 0.67 logMAR units before rtPA injection to 0.48 ± 0.49 logMAR units at 1-month (p < 0.001). Conclusions: The application of r-tPA was a quick and efficacious therapeutic approach for the management of severe fibrinous reactions in TASS after cataract surgery. In a clinical setting, intracameral r-tPA may be useful when rapid visual recovery is needed.
KW - Lens/cataract
KW - biochemistry/physiology
KW - intraoperative complications of cataract surgery
KW - phacoemulsification
KW - postoperative anterior segment problems
UR - http://www.scopus.com/inward/record.url?scp=85102517045&partnerID=8YFLogxK
U2 - 10.1177/11206721211002064
DO - 10.1177/11206721211002064
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C2 - 33719630
AN - SCOPUS:85102517045
SN - 1120-6721
VL - 32
SP - 200
EP - 204
JO - European Journal of Ophthalmology
JF - European Journal of Ophthalmology
IS - 1
ER -