Rapid development of band keratopathy of corneal graft associated with treatment with intracameral recombinant tissue plasminogen activator for postoperative fibrin reaction.

Purpose: To report a corneal transplant complication associated with intracameral recombinant tissue plasminogen activator (rTPA) treatment of postoperative fibrin reaction.
Methods: In a 71-year-old patient, a triple procedure was performed for perforated rheumatic ulcer and secondary cataract.
Results: A dense band keratopathy developed rapidly within 36 hours after the use of intracameral injection of rTPA for the treatment of a dense fibrin clot.
Conclusions: This is the first report of rapid development of massive band keratopathy in a corneal graft after triple procedure and treatment with intracameral rTPA. Intracameral rTPA should be used with caution in patients with attenuated endothelium.