In a prospective study performed between June 1992 and March 1994 19 eyes of 19 patients with dense fibrinous pupillary membranes following cataract surgery were treated with intracameral injections of 25

g recombinant tissue plasminogen activator (r-tPA). Injections were performed between the second and twenty-third postoperative day (mean 5.6±6.9 days). Complete fibrinolysis within one to 4 hours (mean: 3.3±0.89 hours) was observed in 18 (94.7%) eyes. In one (5.3%) eye fibrinolysis was incomplete despite a second injection. In 2 (10.5%) eyes recurrence of a distinct fibrinous membrane was noted which then cleared spontaneously with topical treatment. A small hyphema developed in 2 (10.5%) eyes and intraocular pressure exceeded 25 mm Hg in 2 (10.5%) eyes. No increase of keratopathy nor any toxic intraocular side effect of 25

g intracameral r-tPA was observed throughout the study. The intracameral injection of r-tPA clinically proved to safely accelerate the resorption of dense fibrinous membranes following cataract surgery and thus enhance visual recovery minimizing subsequent complications and systemic or subconjunctival anti-inflammatory treatment.
Key words cataract surgery - fibrin - tissue plasminogen activator