Usefulness of Plasmin Assisted Vitrectomy for Diabetic Macular Edema

Abstract

Abstract: : Purpose: To evaluate the usefulness of plasmin enzyme as an adjunct during vitrectomy for cases with diabetic macular edema. Materials and methods:In preparation of plasmin,we followed the methods descrived by Trese et al for the most part,however an addition of inhibitor of protein denaturation was essential to abstract highly purified plasminogen,and urokinase was safer to activate plasminogen to plasmin avoiding intraocular inflammation.Plasmin enzyme of 0.1 ml(0.2IU)extracted from each patients was injected into the vitreous cavity 10 minutes before starting vitrctomy.Prior to injection,lens extraction and intraocular lens implantation was perfomed.We applied this procedure to eight eyes of eight patients with early stage of diabetic macular edema,and compared this methods with 88eyes treated by vitrectomy without assistance of plasmin.Retinal thickness,visual acuity and fluorescein angiography were evaluated postoperatively. Results: We confirmed that vitreous body detached to the most peripheral area during operation, so that we completed vitrectomy in a much shorter time without any comlications. Visual acuity and macular edema improved in all cases. Conclusion: Autologus plasmin is a useful intraoperative adjunct to furnish vitrectomy easily within shorter surgery time.

Keywords: macula/fovea