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Abstract #5718 Published in IGR 2-1
Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis
Skolnick CA; Fiscella RG; Tessler HH; Goldstein DAAmerican Journal of Ophthalmology 2000; 129:363-366
PURPOSE: To report the use of intracameral tissue plasminogen activator to dissolve fibrinous membranes and break posterior synechiae in patients with acute HLA-B27-positive iridocyclitis with impending pupillary block. METHODS: Two patients with severe acute fibrinous iridocyclitis and seclusion pupillae were identified. Because of the concern of impending pupillary block, intracameral tissue plasminogen activator (12.5 μg in 0.1 ml, Activase; Genentech, Inc, South San Francisco, CA) was injected with a 25-gauge needle through the corneal limbus. RESULTS: Both patients showed complete dissolution of fibrin with disruption of posterior synechiae. There were no adverse events after injection. Neither patient required further invasive intervention, and both fully recovered with medical management. CONCLUSIONS: Intracameral tissue plasminogen activator is a safe and effective agent for patients with severe acute iridocyclitis and pupillary seclusion. Patients with clinical signs suggestive of impending pupillary block glaucoma may be considered for tissue plasminogen activator injection to avoid the possible need for emergency surgical iridectomy and synechiolysis.
Dr. D.A. Goldstein, Department of Ophthalmology/Visual Sciences, University of Illinois, College of Medicine, 1905 W Taylor Street, Chicago, IL 60612-7243, USA
Classification:
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
12.20 Other (Part of: 12 Surgical treatment)
