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August 1993

Tissue Plasminogen Activator and Staphylococcus epidermidis Endophthalmitis

Author Affiliations

From the Department of Ophthalmology (Dr Ryan), University of Minnesota Medical School (Dr Mizener), Minneapolis. Dr Ryan is currently in private practice in Minneapolis; Dr Mizener is currently a resident in the Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City.

Arch Ophthalmol. 1993;111(8):1117-1122. doi:10.1001/archopht.1993.01090080113026

Objective:  To determine whether intraocular administration of tissue plasminogen activator (tPA) speeds clearance of inflammatory debris or prevents fibroproliferative complications in an animal model of endophthalmitis.

Methods:  Aphakic rabbits were given an intraocular dose of Staphylococcus epidermidis organisms known to cause moderate inflammation and to self-sterilize. They were then randomized to receive either tPA or saline injections 2 and 3 days after inoculation. All eyes were graded by one masked clinician seven times, 1 to 28 days after infection. Vitreous samples from selected eyes were cultured.

Results:  Treated and control eyes were found to have no significant difference in inflammatory scores. Although the eyes treated with tPA had more retinal detachments and more positive cultures than control eyes, these numbers were not statistically significant (P=.44 to.71).

Conclusion:  Fibrinolysis with intraocular tPA does not accelerate clearance of inflammation nor decrease fibroproliferative complications in this animal model of endophthalmitis.

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