Abstract
Purpose: :
To evaluate efficacy and complication of autologous plasmin (AP) injected before vitrectomy for rhegmatogenous retinal detachment (RRD).
Methods: :
Intravitreal AP injection (0.2 ml) was performed on the eyes without posterior vitreous detachment (PVD) 20 minutes before vitrectomy for RRD (AP group, n=7). The extent of PVD was judged intraoperatively. Surgical PVD induction was performed and the easiness of the maneuver was graded by a single surgeon. The extent of PVD, easiness of PVD induction and complication including incidence of iatrogenic retinal break was compared to the control eyes which were not injected AP (n=7). In order to evaluate complication, measurement of activated partial thromboplastin time, microbial culture of injected AP was conducted and rate of postoperative intraocular hemorrhage was investigated. Change of visual acuity and the rate of retinal reattachment were compared for the evaluation of long-term surgical outcome.
Results: :
The extent of PVD was larger in the AP group than the control group (p=0.025) and vitreal separation was facilitated by intravitreal AP injection (p=0.034). However, easiness of PVD induction (p=0.744) and frequency of iatrogenic retinal break found in the two groups (1 eye in the AP group, 2 eyes in the control group, p= 0.530) showed no significant difference. No postoperative intraocular hemorrhage nor systemic coagulation abnormality occurred. Postoperative endophthalmitis and positive microbial culture of AP solution were not reported either. There was no significant difference in change of visual acuity and the rate of retinal reattachment between the two groups.
Conclusions: :
Intravitreal AP injection can facilitate vitrectomy for rhegmatogenous retinal detachment without complications.
Clinical Trial: :
http://www.umin.ac.jp/ctr/, R000005509
Keywords: retinal detachment • vitreoretinal surgery