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Case Reports
. 2009:3:91-3.
Epub 2009 Jun 2.

Intravitreal injection of tissue plasminogen activator as treatment for an occluded pars plana glaucoma tube

Irena Tsui  1 , Suzanna Airiani, Angie Wen, Tarek El-Sawy, Howard F Fine, Peter J G Maris Jr
Affiliations
Case Reports

Intravitreal injection of tissue plasminogen activator as treatment for an occluded pars plana glaucoma tube

Irena Tsui et al. Clin Ophthalmol. 2009.

Abstract

Implanting glaucoma tubes through the pars plana in the setting of a corneal transplant is becoming more common, and there are unique problems associated with such a procedure. A 42-year-old man with multiple previous eye surgeries presented with a nonfunctioning pars plana glaucoma tube. There was no view to the tube tip, but it was presumed to be clogged with fibrin. Intravitreal tissue plasminogen activator (tPA) was injected through the pars plana which resulted in intraocular pressure control without further surgery. This new application of intravitreal tPA has not been reported previously. Future research should investigate the optimal effective and safe dose of intravitreal tPA injection to relieve such occlusions.

Keywords: Ahmed Glaucoma Valve; tissue plasminogen activator (tPA).

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Figures

Figure 1
Figure 1
Slit lamp photographs of superotemporal bulbar conjunctiva of the left eye. (A) Before the intravitreal tPA injection, conjunctiva was flat over the Ahmed plate. Note the pericardium (Tutoplast, Costa Mesa, CA) and plate markings. (B) Two months following intravitreal tPA injection, there is a pseudocapsule over the functioning drainage device. Intraocular pressure is controlled with topical medications.
Figure 2
Figure 2
Slit lamp photographs of the left eye taken two months postoperatively. (A) Clear corneal graft with optic capture of a MA60AC (Alcon, Fort Worth, TX) intraocular lens. (B) The tip of the Ahmed tube in the anterior vitreous cavity is not occluded, as visualized by retroillumination.
See this image and copyright information in PMC

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