Introduction: The aim of this paper was to describe the use of r-TPA for fibrin clot dissolution following endophthalmitis.

Clinical Picture: A 74-year-old man presented with painful loss of vision following routine uncomplicated cataract surgery.

Treatment: He underwent standard treatment for postoperative endophthalmitis but despite this, developed a dense fibrin clot. He underwent further intracameral injection of r-TPA.

Outcome: Following the injection, he had complete clot dissolution within 2 hours without any complications.

Conclusion: R-TPA may be used effectively in the treatment of fibrin clots secondary to endophthalmitis following cataract surgery.

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