Recombinant tissue plasminogen activator for treatment of fibrinous membranes after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of recombinant tissue plasminogen activator (TPA) for treatment of fibrinous membranes following cataract surgery.METHODS: 25μg of TPA was injected into the anterior chamber of 15 pseudophakic eyes with moderate to severe fibrinous membranes that developed after cataract surgery.Simultaneously, topical corticosteroid and cycloplegic therapy was continued. Routine follow-up included slit lamp examination and intraocular pressure measurement.RESULTS: Injection of the solution of tissue plasminogen activator into anterior chamber of 15 eyes resulted in complete dissolution of the fibrinous membranes in 9 (60.0%)eyes after 2 hours, and 11 (73.3%) eyes within 1 day. In 3eyes, within a few days after injection, fibrinous membrane recurred. Increased anterior chamber reaction (P=0.54) and corneal edema (P =0.083) were seen after 24hours. No evidence of toxicity was observed as measured by slit-lamp biomicroscopy and intraocular pressure. Finally, expectable stable result was obtained in all of the eyes.CONCLUSION: Safety and high efficacy of TPA in the treatment of fibrinous membranes after cataract surgery are confirmed.

Tissue Plasminogen Activator in the Treatment of Fibrinous Membrane after Cataract Surgery

We injected tPA into the anterior chamber of 43 pesudophakic eyes with moderate to severe fibrinous membrane which had developed following cataract surgery from January, 1990 to August, 1990 at St. Mary's hospital. The results were as follows: 1. Intraocular tPA injection was resulted in complete fibrinolysis within 1 hour in 38 of 43 eyes and patial fibrinolysis in 5 of 43. 2. No corneal endothelial cell loss was found, and tPA did not appear to cause a significant rise in intraocular pressure. 3. Complications of tPA injection included mild, transient, periocular pain(3 eyes), anterior chamber fibrin debris(2 eyes) and anterior chamber hemorrhage(1 eye). The results indicated that tPA is dramatically effective for the clearance of fibrinous membrane after cataract surgery.

Clinical Study of Domestic-made Intraocular Lens(UNI-IOL(R))

I studied twenty cases who underwent domestic-made intraocular lens(IOL; UNI-IOL(R)) implantation from 12th April, 1988 to July 29, 1988. All patients most of them were females, were over 60 years old and followed up over 1 year. The results were as follows: 1. The postoperative final corrected visual acuity of 20/40 or better was noted in 18 eyes(90.0%) and visual acuity below 20/50 was in 2 eyes(10.0%). The reason's of this poor vision were optic atrophy and age related macular degeneration. 2. The final refractive state within +/-1.0D with spherical equivalent was fifty-five percent and only one over -2.0D. 3. The corneal thickness increased mostly(9.8%) at postoperative 3 days and graually returned to the normal level by postoperative fifteen days. 4. Anterior chamber reaction, cells, pigments on the IOL decreased gradually at postoperative period. 5. The percentage loss of corneal endothelium was 13.4% at postoperative 2 months and 14.1% at postoperative 1 year. 6. Partial posterior capsule rupture was developed in one eye during the opera tion and fibrinous membrane and after cataract were developed in one eye.

Clinical Evaluation of Fibrinous Membrane after Extracapsular Cataract Extraction

1380 extracapsular cataract extractions were perfomed from January, 1987 to August, 1988 at St. Mary's Hospital. Among them 88 eyes which developed postoperative fibrinous membrane were evaluated. The incidence of fibrinous membrane was about 6.4%. The fibrinous membrane was developed in 3 to 5 days and resolved within 15 days after surgery in most cases. Mild type of fibrinous membrane was most common and was located on the surgace of the intraocular lens in most cases. Although the presumed causes of the fibrinous membrane were uncertain yet, authors thought that inflammatory reactions from the intraoperative trauma, the remained lens cortex and the posterior chamber lens itself were the causative factors.

The Effect of Depo-Medrol(R) on Fibrinous Membrane Formation after Posterior Charmber Lens Implantation

I analyzed the incidence of fibrinous membrane formation in the eyes that received extracapsular cataract extraction and posterior chamber lens implantation. There was statistically significant difference between the incidence of fibrinous membrane formation in the eyes that received sub-Tenon's injection of Depo-Medrol(R) at the end of surgery(7.9%) and that in the eyes that did not receive it(34.8%)(p<0.025).

Clinical experience of hydrogel soft intraocular lenses

Twenty-six soft intraocular lenses were implanted in twenty-six senile cataract patients from luly 16, 1987, to April 15, 1988 at Kangnam St. Mary's Hospital, Seoul, Korea. The average age of the patients was seventy-six with a range from fifty-five to eight nine years old. Of the twenty-six patients at the 12 months follow up 87.5% have arhieved visual acuity of 20/40 or better. The average central corneal endothelial cell loss at postoperative 7 days and 3 months were 9.8% and 12.3% respectively. Complications were observed in six patients. Two patients had preexisting retinal and optic diseases and one had a fibrinous membrane. Three patients had transient pigmentary precipitates on IOL surface.