title: Pediatric traumatic macular hole: results of autologous plasmin enzyme-assisted vitrectomy.
abstract: OBJECTIVE
  To review our experience with plasmin-assisted vitrectomy surgery for the treatment of pediatric macular holes.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Thirteen pediatric patients aged one to 15 years with a traumatic macular hole underwent surgical repair. All patients underwent surgery between February 1997 and March 2005 with autologous plasmin enzyme-assisted vitrectomy. After induction of posterior vitreous detachment (PVD), vitrectomy with membrane peeling and gas or silicone oil injection were performed followed by prone positioning for seven days. Main outcome measures included anatomic closure rate, visual outcome, and ocular complications.
  
  
  RESULTS
  The macular hole was closed successfully in 12 (92%) of 13 cases. Of the 12 patients for whom vision could be measured, 11 patients (92%) had visual acuity improvement of 2 or more lines and six patients (50%) achieved vision of 20/50 or better; all of the patients achieved vision better than 20/200. The visual improvement was statistically significant (P = .005, Wilcoxon signed-rank test). Surgical complications included cataract formation in one patient and retinal detachment in one patient.
  
  
  CONCLUSIONS
  Autologous plasmin enzyme may be a helpful adjunct when performing vitrectomy for traumatic macular holes.
authors.affiliation: Associated Retinal Consultants, PC, Royal Oak, Michigan 48073, USA.
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Wu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Drenser
authors.forename: Michael T
authors.initials: MT
authors.lastname: Trese
authors.forename: George A
authors.initials: GA
authors.lastname: Williams
authors.forename: Antonio
authors.initials: A
authors.lastname: Capone
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005131:Eye Injuries / Q000209:etiology / Q000628:therapy*; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D009887:Ophthalmoscopy; D012160:Retina / Q000293:injuries*; D012167:Retinal Perforations / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D005343:Fibrinolytic Agents; D005341:Fibrinolysin