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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。
Objective: To investigate the effect of recombinant tissue plasminogen activator (tPA) on fibrin membrane after cataract surgery. Methods: Fifteen patients with moderate to severe fibrin membrane after implantation of cataract and intraocular lens implantation were injected with 25μgtPA anterior chamber. At the same time give continuous local hormones and cycloplegic treatment, as well as conventional slit lamp examination and intraocular pressure monitoring. RESULTS: Of the 15 eyes injected with tPA in the anterior chamber, 9 (60.0%) completely dissolved the fibrin membrane after 2 hours and 11 (73.3%) completely dissolved within 1 day. 3 days after tPA intraocular injection of fibrin membrane recurrence. Anterior chamber responses (P = 0.54) and corneal edema (P = 0.083) were observed to increase after tPA 24 h injection. Slit lamp and intraocular pressure examination found no significant side effects. The experiment obtained the expected stable result. CONCLUSION: Anterior chamber injection of tPA is safe and effective for the treatment of fibrin membranes appearing after cataract surgery. Due to the small number of cases, further observation is needed.