J Korean Ophthalmol Soc.  2011 Jul;52(7):825-831. 10.3341/jkos.2011.52.7.825.

Efficacy of Autologous Plasmin-Assisted Vitrectomy for Rhegmatogenous Retinal Detachment

• Park C
• Lee SH
• Heo JW
• Chung H

• KMID: 2214707
• DOI: http://doi.org/10.3341/jkos.2011.52.7.825

Abstract

PURPOSE
To evaluate the efficacy and complication of autologous plasmin (AP) injected before vitrectomy for rhegmatogenous retinal detachment (RRD).
METHODS
Intravitreal AP injection (0.2 ml) was performed on the eyes without posterior vitreous detachment (PVD) 20 minutes before the vitrectomy for RRD. The extent of PVD was evaluated intraoperatively. Surgical PVD induction was performed and the ease of the procedure was graded. The extent of PVD, ease of PVD induction, and complications (including incidence of iatrogenic retinal break) were compared to those of the control eyes. In order to evaluate complications and measure activated partial thromboplastin time, a microbial culture of injected AP was performed and the rate of postoperative intraocular hemorrhage was investigated. Change in visual acuity and the rate of retinal reattachment were compared in order to evaluate the long-term surgical outcome.
RESULTS
The extent of PVD was greater in the AP group than in the control group, and vitreal separation was facilitated by intravitreal AP injection. However, ease of PVD induction and frequency of iatrogenic retinal break found were not significantly different between cases and controls. Neither postoperative intraocular hemorrhage nor systemic coagulation abnormality occurred. Postoperative endophthalmitis and positive microbial culture of the AP solution were also not reported. There was no significant difference in the change in visual acuity and the rate of retinal reattachment between the two groups.
CONCLUSIONS
Intravitreal AP injection can facilitate vitrectomy for RRD and has no effect on the rate of retinal reattachment.

Keyword

Autologous plasmin; Rhegmatogenous retinal detachment; Vitrectomy

MeSH Terms

Endophthalmitis
Eye
Fibrinolysin
Hemorrhage
Incidence
Partial Thromboplastin Time
Retinal Detachment
Retinal Perforations
Retinaldehyde
Visual Acuity
Vitrectomy
Vitreous Detachment
Fibrinolysin
Retinaldehyde

Figure

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  Figure 1. Extent of posterior vitreous detachment. 0: none; 1: partial; 2: to equator: 3: to vitreal base.

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  Figure 2. Easiness of posterior vitreous detachment (PVD) induction. 0: with microforceps or pick; 1: by high suction on disc; 2: by low suction on disc; 3: on high suction core vitrectomy; 4: on low suction core vitrectomy; 5: complete PVD with Weiss ring. AP group = autologous plasmin group.

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  Figure 3. Easiness of vitreal separation. 0: present on vitrectomy; 1: very easy; 2: easy; 3: moderately difficult; 4: difficult; 5: failure. AP group = autologous plasmin group.

Reference

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