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Twenty-five micrograms of human recombinant tissue plasminogen activator (tPA) was injected via the corneoscleral limbus of 14 postvitrectomy aphakic eyes with prominent pupillary fibrin membranes. Fibrinolysis by tPA was initiated by thirty minutes after the injection, and the fibrin membrane was completely dissolved within sixty minutes. No toxicity attributed to tPA was observed clinically. Intraocular fluid was obtained during fluid-gas exchange after complete dissolution of fibrin and analyzed for decomposed fibrin products (FDP). Intraocular FDP was significantly higher (160 +/- 250 micrograms/ml) than normal after tPA treatment. Intraocular tPA administration is a potent modality to treat postvitrectomy fibrin membrane. Fluid-gas exchange must be performed to eliminate as much FDP as possible to reduce postoperative inflammation.
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