This ‘Stop Press’ article in the February 2010 issue of Drug Safety Update notes that there have been five reports made to the MHRA of opacification of intraocular lenses associated with off-label intraocular (intracameral) injections of recombinant tissue plasminogen activator (rTPA).  In all cases, this was for the treatment of uveitis-related fibrosis.

The article notes that the exact mechanism for this adverse effect is unknown, and that off-label intravitreal injection may also pose similar risks.  All relevant professionals should be aware of this risk and ensure adequate follow-up of patients at risk of this side effect.  Any further cases of intraocular lens opacification should be reported to the MHRA, who will keep this issue under review.