Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery

Perach Osaadon, Nadav Belfair, Itay Lavy, Eyal Walter, Jaime Levy, Raimo Tuuminen, Asaf Achiron, Boris Knyazer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)200-204
Number of pages5
JournalEuropean Journal of Ophthalmology
Volume32
Issue number1
DOIs
StatePublished - Jan 2022

Keywords

  • Lens/cataract
  • biochemistry/physiology
  • intraoperative complications of cataract surgery
  • phacoemulsification
  • postoperative anterior segment problems

Fingerprint

Dive into the research topics of 'Intracameral r-tPA for the management of severe fibrinous reactions in TASS after cataract surgery'. Together they form a unique fingerprint.

Cite this