title: Treatment of vitreomacular traction with intravitreal ocriplasmin preceded by anterior chamber paracentesis: case reports.
abstract: OBJECTIVE
  To evaluate the efficacy of an intravitreal ocriplasmin injection using anterior chamber paracentesis to release symptomatic vitreomacular traction (VMT).
  
  
  METHODS
  Five patients with symptomatic VMT were enrolled. All patients underwent a complete ophthalmologic examination including acquisition of spectral-domain optical coherence tomography. Before intravitreal injection of ocriplasmin, anterior chamber paracentesis was performed in the study eye to induce mild ocular hypotonia. Control visits were performed the day after the injection, at 1 week, and after 1, 2, and 3 months.
  
  
  RESULTS
  In 4 patients, we had complete release of VMT and visual improvement after the intravitreal ocriplasmin injection preceded by anterior chamber paracentesis. No adverse events were observed.
  
  
  CONCLUSIONS
  In our small case series, anterior chamber paracentesis performed before intravitreal ocriplasmin seemed to increase the efficacy of the drug in the resolution of symptomatic VMT. Our success estimate is imprecise due to small sample size (95% confidence interval 0.28 to 0.99) and no definitive conclusion can be reached. Further research is worth being conducted to assess the potential usefulness of paracentesis before ocriplasmin injection to increase vitreoretinal traction release rate.
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence - Italy.
authors.forename: Stanislao
authors.initials: S
authors.lastname: Rizzo
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence - Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Bacherini
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence - Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Abbruzzese
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence - Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Giuntoli
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence - Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Virgili
mesh_terms: D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000601:surgery; D005128:Eye Diseases / Q000188:drug therapy*; D005260:Female; D005341:Fibrinolysin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008875:Middle Aged; D019152:Paracentesis; D010446:Peptide Fragments / Q000627:therapeutic use*; D012164:Retinal Diseases / Q000188:drug therapy*; D000267:Tissue Adhesions; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000187:drug effects*
chemical_list: D005343:Fibrinolytic Agents; D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin