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Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis.
Am J Ophthalmol 2000; 129(3):363-6AJ

Abstract

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 seclusio pupillae were identified. Because of the concern of impending pupillary block, intracameral tissue plasminogen activator (12.5 microg in 0.1 ml, Activase; Genentech, Inc, South San Francisco, California) 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.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, Chicago, IL 60612-7243, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

10704553

Citation

Skolnick, C A., et al. "Tissue Plasminogen Activator to Treat Impending Pupillary Block Glaucoma in Patients With Acute Fibrinous HLA-B27 Positive Iridocyclitis." American Journal of Ophthalmology, vol. 129, no. 3, 2000, pp. 363-6.
Skolnick CA, Fiscella RG, Tessler HH, et al. Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis. Am J Ophthalmol. 2000;129(3):363-6.
Skolnick, C. A., Fiscella, R. G., Tessler, H. H., & Goldstein, D. A. (2000). Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis. American Journal of Ophthalmology, 129(3), pp. 363-6.
Skolnick CA, et al. Tissue Plasminogen Activator to Treat Impending Pupillary Block Glaucoma in Patients With Acute Fibrinous HLA-B27 Positive Iridocyclitis. Am J Ophthalmol. 2000;129(3):363-6. PubMed PMID: 10704553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis. AU - Skolnick,C A, AU - Fiscella,R G, AU - Tessler,H H, AU - Goldstein,D A, PY - 2000/3/8/pubmed PY - 2000/3/8/medline PY - 2000/3/8/entrez SP - 363 EP - 6 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 129 IS - 3 N2 - 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 seclusio pupillae were identified. Because of the concern of impending pupillary block, intracameral tissue plasminogen activator (12.5 microg in 0.1 ml, Activase; Genentech, Inc, South San Francisco, California) 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. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/10704553/Tissue_plasminogen_activator_to_treat_impending_pupillary_block_glaucoma_in_patients_with_acute_fibrinous_HLA-B27_positive_iridocyclitis L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002939499003505 DB - PRIME DP - Unbound Medicine ER -