Treatment of Total Hyphema Following Trauma and Surgery with Tissue Plasminogen Activator.

Chung, Sang Moon; Koo, Tae Hyung; Kim, Min Ho; Kim, Sung Mi

Original Article

Journal of the Korean Ophthalmological Society 1997;38(4):692-697.
Published online April 1, 1997.

Treatment of Total Hyphema Following Trauma and Surgery with Tissue Plasminogen Activator.

Sang Moon Chung, Tae Hyung Koo, Min Ho Kim, Sung Mi Kim

¹Department of Ophthalmology, Catholic University Medical College, Seoul, Korea.
²Department of Ophthalmology, Uijongby St. Mary`s Hospital.
³Department of Ophthalmology, St. Vincent`s Hospital.

조직 플라스미노겐 활성제를 이용한 전체전방출혈의 치료

정상문(Sang Moon Chung),구태형(Tae Hyung Koo),김민호(Min Ho Kim),김성미(Sung Mi Kim)

Abstract

Delayed clearing from the total hyphema resulting from ocular trauma and surgery causes intractable glaucoma and corneal staining by blood-pigments such as hemoglobin and small amounts of hemosiderin. The management of hyphema includes supportive medical care such as bed rest and surgical procedures such as paracentesis and removal of blood clot to enhance the secretory function of trabecular meshwork. However, surgical intervention has many complications and should be used only when it is absolutely necessary. We used the recombinant intraocular tissue plasminogen activator as a method for minimizing complications and sequeles in three patients with total hyphema. Hyphema resolved in all patients who had been treated with 10ug of recombinant tissue plasminogen activator following 5 days medical treatment. In study, we experienced a case of vitreous hemorrhage. In conclusion, we recommend that eyes with complicated large or total hyphema may be considered for intracameral tissue plasminogen activator as a first procedure comparing to surgical intervention, but further invesigation is needed for timing and dosage of drug usage.

Key Words: Hyphema;Tissue plasminogen activator