PMID: 8590254Jan 1, 1995Paper

Treatment of failing glaucoma filtering cystic blebs with tissue plasminogen activator (tPA)

Journal of Ocular Pharmacology and Therapeutics : the Official Journal of the Association for Ocular Pharmacology and Therapeutics
P F LeeD M Hotaling

Abstract

Tissue plasminogen activator (tPA) is a clot-specific fibrinolytic agent shown to be effective in decreasing postsurgical fibrin formation and enhancing filtration after trabeculectomy. To evaluate the efficacy of tPA on blebs showing clinical evidence of failure, a retrospective analysis was performed on 20 eyes of 20 glaucoma patients with failing or failed cystic filtering bleb treated with tPA intrableb and/or intracameral injection. The average pre-tPA intraocular pressure (IOP) was 18.0 +/- 7.2 mmHg and post-tPA was 12.9 +/- 6.2 mmHg. Fifteen of 20 eyes (75%) were able to maintain their IOP at or below target level, in the follow-up period of 3 to 7 months. Eight of the 15 eyes with successful outcome were free of glaucoma medication. Patients experienced no pain or irritation during and after the injection of tPA. No adverse effects on visual acuity or major complications were encountered. Transient mild complications related to tPA injections were subconjunctival hemorrhage (2 eyes), hyphema (1 eye) and hypotony (6 eyes). The revision of failing cystic bleb by tPA intrableb and/or intracameral injection may be considered as a useful adjunct with low risk in management of failing cystic blebs. A well designed clinical tr...Continue Reading

References

Sep 15, 1990·American Journal of Ophthalmology·R H Ewing, R L Stamper
Jul 15, 1989·American Journal of Ophthalmology·G J JaffeG W Abrams
Sep 1, 1988·Ophthalmology·C U RichterI Brill
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Sep 1, 1988·Ophthalmology·D R Scott, H A Quigley
May 1, 1993·Archives of Ophthalmology·M M OlivierD H Shin

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Citations

Sep 13, 2011·Experimental Eye Research·Tine Van BergenIngeborg Stalmans
Apr 10, 2007·Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society·Stephanie M SchimJune Miller
Sep 22, 1999·Journal of Biomedical Materials Research·C A BoswellS K Williams
Apr 17, 2004·International Ophthalmology Clinics·Sean-Paul A AtreidesAdam C Reynolds
Oct 12, 2000·Eye·M F CordeiroP T Khaw

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