Intracameral tissue plasminogen activator in trabeculectomy: a 1-year prospective, randomized, controlled study

Dana Barequet*, Eldar Rosenfeld, Gilad Rabina, Gabi Shemesh, Shimon Kurtz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the safety and the adjunctive effect of intracameral tissue plasminogen activator (tPA) in trabeculectomy for patients with primary open-angle glaucoma (POAG). Methods: This was a prospective, randomized study consisting of patients with POAG who underwent trabeculectomy in Tel Aviv Medical Center between March 2013 and December 2014. Patients were randomly assigned to two groups: Group 1 underwent mitomycin C (MMC) trabeculectomy and group 2 underwent MMC trabeculectomy with intracameral tPA. Complete and overall success were defined as intraocular pressure (IOP) between 5 and 18 mmHg and at least 30% IOP drop without and with or without anti-glaucoma treatment, respectively. Results: A total of 16 patients (seven females and nine males) were recruited, and eight patients were assigned to each group. IOP at presentation was 27 ± 5.3 mmHg and 25.3 ± 5.1 mmHg, compared to 13.7 ± 4.3 mmHg and 10.6 ± 2.0 at 12 months (p < 0.0001) for groups 1 and 2, respectively. Complete success at 12 months was achieved in 62.5% of group 1 compared to 87.5% of group 2 (p = 0.28). Overall success was achieved in 87% compared to 100% of patients at 12 months (p = 0.33). No evidence of complications attributable to tPA was found. Conclusions: Augmentation of tPA during MMC trabeculectomy may have better complete and overall success rates, compared to MMC trabeculectomy. The safety profile was similar for both groups.

Original languageEnglish
Pages (from-to)1641-1646
Number of pages6
JournalInternational Ophthalmology
Issue number7
StatePublished - 1 Jul 2020


  • Glaucoma
  • Mitomycin C
  • Tissue plasminogen activator
  • Trabeculectomy


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