Use of autologous plasmin during vitrectomy for diabetic maculopathy.
OBJECTIVE
To evaluate the efficacy of autologous plasmin enzyme as an adjunct to vitrectomy in diabetic macular edema.


METHODS
Plasmin derived from autologous blood was injected intravitreally into seven eyes 15 min before vitreous surgery. The development and progression of a posterior vitreous detachment (PVD) was followed, and the time required for vitreous removal was measured. Both pre- and postoperative visual acuities and optical coherence tomography (OCT)-determined macular thickness were measured.


RESULTS
In the seven eyes in which plasmin was used, a PVD developed approximately 5 min after the injection and was confirmed to extend to the far periphery. In all cases, the removal of the vitreous was completed in a shorter time and no complications were observed. A restoration of the shape of the macula was observed in all cases. The visual acuity improved by two or more lines in four eyes, and remained unchanged in the remaining three eyes.


CONCLUSIONS
Autologous plasmin alone will create a full PVD, and eliminates the need for a mechanical creation of a PVD. Thus, plasmin is a safe and effective adjunct to vitreous surgery for the treatment of diabetic maculopathy.
Department of Ophthalmology, Juntendo University, Urayasu Hospital, Urayasu, Chiba, Japan.
T
T
Sakuma
M
M
Tanaka
J
J
Inoue
A
A
Mizota
M
M
Souri
A
A
Ichinose
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000187:drug effects*
D005343:Fibrinolytic Agents; D005341:Fibrinolysin