重组组织型纤维蛋白酶原激活剂治疗白内障手术后的纤维蛋白膜(英文)

Recombinant tissue plasminogen activator for treatment of fibrinous membranes after cataract surgery

目的:研究重组组织型纤维蛋白酶原激活剂(tPA)对于治疗白内障手术后的纤维蛋白膜的作用。方法:选取白内障人工晶状体植入术后中度至重度纤维蛋白膜15例,行25μgtPA前房注射。同时给与持续的局部激素和睫状肌麻痹剂治疗,以及常规的裂隙灯检查和眼压监测。结果:在前房注射tPA的15眼中,其中9眼(60.0%)在2h后纤维蛋白膜完全溶解,11眼(73.3%)在1d内完全溶解。3眼内注射tPA几天后纤维蛋白膜复发。注射tPA24h后可观察到前房反应(P=0.54)和角膜水肿(P=0.083)增加。裂隙灯和眼压检查未发现明显的毒副作用。实验得到预期的稳定结果。结论:前房注射tPA用于治疗白内障手术后出现的纤维蛋白膜具有安全有效的作用。由于病例数量较少,需要进一步观察。

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 （60.00） eyes after 2 hours, and 11 （73.3%） eyes within 1 day. In 3 eyes, 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.