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Therapeutic Option for Lignous Conjunctivitis with Topic Fibrinolysis

Sauder G., Hugger P., von Buch C.,
Ruprecht-Karls-Universität Heidelberg, Fakultät für klinische Medizin Mannheim, Augenklinik (Mannheim)

Purpose: To asses the efficacy of a combination of toical application of anistreplase (Eminase R) and topical and systemic heparin as a therapeutic option for lignous conjunctivitis as a rare, non-infectious conjunctivitis in children with a homocygot deficiency of plasminogen.
Patients and methods: A two yea old girl with lignous conjunctivitis had a nearly complete occlusion of the eyelids due to a ankyloblepharon. The girls had a homozygot deficiency of plasminogen with a rest activity of 8%. She underwent surgical removal of the conjunctival membranes to regain opening of both eyes. Postoperatively she was treated with systemic and topical Heparin every hour. After a additional removal of fibrinous membranes after three weeks the patient was treated with Anistreplase eyedrops every hour.
Results: Under the topical application of Eminase R eye drops the fibrinous membranes completely disappeared. The child is now treated only with Eminase ED 3 x daily and Heparin ointment at night. In the follow up period of three month no fibrin exsudation was visible.
Conclusions: Because a causal therapy with plasminogen in lignous conjunctivitis is not available at the moment, the topical application of fibrinolytic Eminase R could be a therapeutic option.