Peer-reviewed veterinary case report
Effect of immediate tPA injection on eye fibrin after dog cataract
By Mancuso, Laura A et al.·Published in Veterinary ophthalmology·2019·Animal Eye Care·View original on PubMed →
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Original publication title: Effect of immediate postoperative intracameral tissue plasminogen activator (tPA) on anterior chamber fibrin formation in dogs undergoing phacoemulsification.
- Species:
- dog
Plain-English summary
A group of dogs undergoing cataract surgery (phacoemulsification) received a medication called tPA to see if it would help prevent complications like fibrin formation in the eye. After surgery, about 68% of the dogs developed some fibrin, with no significant difference between those that received tPA and those that did not. Both groups also experienced similar rates of increased eye pressure, which can lead to glaucoma. Ultimately, using tPA didn't seem to help reduce these issues after surgery, and both groups needed additional treatment at the same rate.
People also search for: dog cataract surgery complications · tPA for dogs eye surgery · dog eye pressure treatment
Abstract
OBJECTIVE: To evaluate the postoperative effect of intracameral tPA (alteplase; Activase®, Genentech, San Francisco, CA), administered at immediate conclusion of phacoemulsification, on anterior chamber fibrin formation in dogs. PROCEDURES: Forty-one dogs (82 eyes) undergoing bilateral phacoemulsification received 25 μg/0.1 mL intracameral tPA in one eye and 0.1 mL unmedicated aqueous vehicle in the contralateral eye immediately after corneal incision closure. Intraocular pressure (IOP) was measured, and severity of anterior chamber fibrin formation, aqueous flare, pigment precipitates on the intraocular lens (IOL) implant, posterior capsular opacification (PCO), and corneal edema were graded at approximately 1 week, 2-3 weeks, 4-6 weeks, 8-12 weeks, and greater than 3 months postoperatively. RESULTS: Anterior chamber fibrin developed postoperatively in 68.3% of dogs (28/41) and 50% of eyes (41/82). In tPA-treated eyes, 53.7% (22/41) developed fibrin compared to 46.3% of control eyes (19/41). Some degree of postoperative ocular hypertension (POH) occurred in 53.7% of dogs (22/41) and 36.5% of eyes (30/82). In tPA-treated eyes, 34.1% (14/41) experienced POH compared to 39% of control eyes (16/41). Additional intracameral tPA injection was later required in 29.3% of both tPA-treated (12/41) and control eyes (12/41). CONCLUSIONS: Administration of intracameral tPA at immediate conclusion of canine phacoemulsification had no clinically observable effect on anterior chamber fibrin incidence at any time point. tPA-treated eyes showed no prophylaxis against POH or secondary glaucoma compared to control eyes and received late postoperative tPA injections at the same frequency as control eyes.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30773778/