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Two patients presenting with acute anterior uveitis (AAU) and severe fibrinous reaction in the anterior chamber were given an injection of intracameral tenecteplase (50 microgram/0.1 ml). In both patients with AAU, complete rapid fibrin resolution and synechiolysis occurred within three days after intracameral tenecteplase injection. Significant visual acuity improvement was also seen in both patients and there were no complications observed throughout the follow-up duration of up to six months after administration of treatment. As tenecteplase has many superior properties compared to other medications in its class and can also be diluted and stored for up to a year under specific conditions, it may be an efficacious, safe and cost-effective means of treating severe AAU with fibrin formation.