title: Microplasmin (ocriplasmin) in pediatric vitreoretinal surgery: update and review.
abstract: OBJECTIVE
  To discuss the potential role of microplasmin (ocriplasmin) as a surgical adjunct to vitrectomy in pediatric vitreoretinopathies.
  
  
  METHODS
  Literature review of the laboratory and clinical evidence to date for the use of both autologous plasmin enzyme as an adjunct to vitrectomy and more recently recombinant microplasmin (ocriplasmin) as monotherapy for focal vitreomacular traction in adults.
  
  
  RESULTS
  Autologous plasmin enzyme is currently being used as a surgical adjunct to vitrectomy, with supporting Levels 2 and 3 published evidence in a range of pediatric vitreoretinopathies including Stage 5 retinopathy of prematurity and congenital X-linked retinoschisis. The availability of autologous plasmin enzyme is limited. In recent Phase 3 clinical trials, intravitreal ocriplasmin versus sham injection resulted in resolution of focal vitreomacular traction in 27% versus 10% (P < 0.001, n = 652).
  
  
  CONCLUSIONS
  Ocriplasmin may potentially be used as a surgical adjunct to vitrectomy in place of autologous plasmin enzyme. A Phase 2, randomized, placebo-controlled surgical trial is under way to assess this.
authors.affiliation: William Beaumont Hospital, Royal Oak, Michigan, USA. chien22@yahoo.com
authors.forename: S Chien
authors.initials: SC
authors.lastname: Wong
authors.forename: Antonio
authors.initials: A
authors.lastname: Capone
mesh_terms: D000293:Adolescent; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010446:Peptide Fragments / Q000627:therapeutic use*; D014821:Vitrectomy; D057586:Vitreoretinal Surgery
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin