Enzymotherapy of toxic anterior segment syndrome after phacoemulsification

Purpose . To investigate the efficacy of recombinant prourokinase (RPU) treatment in patients with toxic anterior segment syndrome after phacoemulsification. Material and methods . We observed 123 patients (123 eyes) with toxic anterior segment syndrome after phacoemulsification; patients of the group I (n = 30) received only antiinflammatory treatment; in treatment of patients of the group II (n = 31), instillations of the RPU solution were used, in the group III (n = 31), RPU solution was injected subconjunctivally, in the group IV (n = 31) – RPU solution electrophoresis was used. Treatment result analysis was carried out within 30 days. Results . Initial mean visual acuity in groups was 0.09 ± 0.04; 0.1 ± 0.04; 0.09 ± 0.04; 0.08 ± 0.04, and was virtually the same (p > 0.05). In 24 hours after treatment initiation, mean visual acuity in the group III was higher, than in the others. In three days and up to the end of observation period, the lowest mean visual acuity was noted in the group I (p < 0.05). Anterior chamber assessment showed that beginning from the first 24 hours after treatment initiation, in groups III and IV, fibrin lysis in the anterior chamber was more pronounced, than in groups I and II (p < 0.05); by the end of the observation period, worst indices of anterior chamber state were found in the group I (p < 0.05), in other groups, they were almost identical (p < 0.05). When using RPU, no allergic reaction was noted. Conclusions . RPU use in combined toxic anterior segment syndrome therapy after phacoemulsification allows increasing visual acuity, reducing convalescence time, and reducing the number of laser dissections. It was established that all methods of RPU administration are effective. RPU may be administered as eye drops on an outpatient basis, receiving efficacy similar to other administration methods.