Plasmin enzyme-assisted vitreoretinal surgery in congenital X-linked retinoschisis: surgical techniques based on a new classification system.
OBJECTIVE
To review the surgical outcome of autologous plasmin enzyme-assisted vitreoretinal surgery in managing complications associated with congenital X-linked retinoschisis (CXLRS).


METHODS
Medical records of 20 patients (22 eyes) with CXLRS complications, treated with autologous plasmin enzyme-assisted vitreoretinal surgery, were reviewed. Surgical techniques were adapted according to a new CXLRS classification.


RESULTS
Median age of the cohort was 3.5 years. Indications for surgical intervention included 8 eyes with schisis involving or threatening the macula, 7 eyes with rhegmatogenous retinal detachment, 4 eyes with tractional retinal detachment, 1 eye with vitreous and intraschisis hemorrhage, 1 eye with obstruction of the macula by an overhanging bullous schisis cavity, and 1 eye with macular pucker. Ninety-one percent (20/22) of eyes had retinal attachment postoperatively after an average of 1.3 procedures per eye. Of the eyes in which visual acuity was measured, 53% (8/15) improved, 33% (5/15) had no change, and 13% (2/15) lost vision.


CONCLUSIONS
Plasmin enzyme-assisted vitreoretinal surgery is a safe and effective method for managing the complications associated with CXLRS. Most patients had improved or stable postoperative visions.
Associated Retinal Consultants, PC, Royal Oak, Michigan 48073, USA.
Wei-Chi
WC
Wu
Kimberly A
KA
Drenser
Antonio
A
Capone
George A
GA
Williams
Michael T
MT
Trese
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000209:etiology / Q000628:therapy*; D041441:Retinoschisis / Q000145:classification* / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000628:therapy*
D005343:Fibrinolytic Agents; D005341:Fibrinolysin