May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Autologous Plasmin Enzyme to Assist in Creating a Posterior Vitreous Detachment in Retinopathy of Prematurity
Author Affiliations & Notes
  • M.S. Ibarra
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • A. Capone
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • Jr
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • M.K. Hartzer
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • G.A. Williams
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • M.T. Trese
    Ophthalmology, Associated Retinal Consultants, Beaumont Eye Institute, Royal Oak, MI
  • Footnotes
    Commercial Relationships  M.S. Ibarra, None; A. Capone, Jr., None; M.K. Hartzer, NuVue Technologies I, E, P; G.A. Williams, NuVue Technologies I, P; M.T. Trese, NuVue Technologies I, P.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1944. doi:
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      M.S. Ibarra, A. Capone, Jr, M.K. Hartzer, G.A. Williams, M.T. Trese; Autologous Plasmin Enzyme to Assist in Creating a Posterior Vitreous Detachment in Retinopathy of Prematurity . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1944.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:Autologous plasmin enzyme (APE) has previously been reported to be helpful in facilitating vitreous separation in complicated vitreoretinal surgery for diabetic retinopathy and macular holes in both adult and pediatric populations. The purpose of this study is to determine if APE can be used to induce a posterior vitreous detachment (PVD) in retinopathy of prematurity (ROP). It is generally felt that mechanically a PVD is not possible in these infants due to their strong vitreoretinal junction adherence. Methods:Retrospective, noncomparative interventional case series involving infants, without previous intraocular surgery, who underwent APE assisted vitrectomies for ROP stage 4B or 5 (open–funnel configuration). Intra–operative usefulness of APE was graded by the ability to observe a spontaneous or easy to create PVD in the infant eye. Results:Eleven eyes of 10 patients underwent surgery for stage 4B (4 eyes) or stage 5 (7 eyes) ROP. The average gestation age at birth was 25 weeks (range 23 to 27 weeks) and the average birth weight was 605 grams. All 11 eyes had previous PRP and/or cryotherapy for threshold ROP. Three of the stage 5 ROP eyes had previous scleral buckle surgery. The average post–conceptual age at time of APE assisted surgery was 59 weeks (range 37 to 78 weeks). Eight eyes (73%) underwent lens–sparing vitrectomies while 3 eyes (27%) underwent lensectomy/vitrectomy surgeries. Intraoperatively, 3 eyes (27%) had a spontaneous hyaloid separation. Seven eyes (64%) were noted to have easy hyaloidal separation and epiretinal dissections from the retinal surface. In one eye, retinal folds were observed to be easily dissected from the posterior lense capsule. On the last followup examination, 8 (73%) had an attached central retina. Three eyes (27%) had a detached central retina with subretinal blood or exudates. Conclusions:APE can cause a PVD and may be a useful adjunct to vitreous surgery in infants with stage 4B or 5 ROP.

Keywords: retinopathy of prematurity • vitreous • enzymes/enzyme inhibitors 
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