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M. Tanaka, T. Sakuma, M. Souri, A. Ichinose; Plasmin Enzyme Assisted Vitrectomy for Stage 3 Macular Hole . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4866.
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Purpose: To evaluate the efficacy and safety of autologous plasmin as an adjunct used during vitrectomy for stage 3 macula hole (MH). Materials and Methods: Clinical course and final outcome of five eyes of five patients with stage 3MH underwent plasmin assisted vitrectomy were compared with 77 eyes of stage 3 MH vitrectomized without plasmin. In addition to the changes of visual acuity and closure rate of MH, transformation of size and shape of MHs were examined continuously by optical coherence tomography. And usefulness of plasmin were investigated. Results: Our previous study showed that 81 % of stage 3 MHs closed by completing posterior vitreous detachment (PVD) and SF6 gas injection. And final closure was obtained by adding internal limiting membrane (ILM) peeling in 91 % of MHs. On the otherhand, complete PVD was observed by injecting plasmin in five cases, however all cases needed ILM peeling to close MHs. Procedures such as plasmin injection alone, plasmin + SF6 gas, plasmin + SF6 gas + vitrectomy were not enough to close MHs. No complications were noted except for peripheral tear formed following PVD by plasmin in one eye. Conclusion: Although plasmin injection was very useful to complete PVD and made operations easier within shorter time, ILM peeling was needed to close stage 3 MHs.
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