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Autologous plasmin-assisted vitrectomy for stage 5 retinopathy of prematurity: a preliminary trial
Yasutomo Tsukahara1, Shigeru Honda, Hisanori Imai
1Division of Ophthalmology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan. tsuka@med.kobe-u.ac.jp
Insights
Autologous plasmin (AP)-assisted vitrectomy shows promise for treating stage 5 retinopathy of prematurity (ROP). This method successfully removed membranes and reattached retinas in all treated infants, indicating potential benefits for severe ROP cases.
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Stage 5 ROP represents a severe form with retinal detachment and proliferative membranes, often requiring surgical intervention.
Purpose of the Study:
- To evaluate the efficacy of autologous plasmin (AP)-assisted vitrectomy in managing stage 5 retinopathy of prematurity (ROP).
Main Methods:
- An interventional case series involving six eyes of four infants with stage 5 ROP.
- AP (0.03-0.22 IU) was administered into the vitreous cavity after lensectomy and membrane dissection.
- The proliferative membrane was treated after 15-30 minutes of incubation.
Main Results:
- Successful removal of the proliferative membrane was achieved in all cases without causing iatrogenic retinal breaks.
- Complete reattachment of the posterior pole retina was observed in 100% of the treated eyes.
- No significant complications were noted during the 11-14 month follow-up period.
Conclusions:
- Autologous plasmin (AP) assisted vitrectomy appears to be a beneficial adjunctive treatment for stage 5 retinopathy of prematurity (ROP).
- The technique facilitated membrane removal and achieved favorable anatomical outcomes in severe ROP cases.
Purpose:
To evaluate the efficacy of autologous plasmin (AP)-assisted vitrectomy for stage 5 retinopathy of prematurity (ROP).
Design:
Interventional case series.
Methods:
Six consecutive eyes of four children with stage 5 ROP were treated. The patients' ages at the surgery ranged from five to eight months after birth. Four eyes showed closed-closed configuration and two eyes showed open-open configuration. After lensectomy and dissection of the anterior proliferative membrane, 0.03 to 0.22 International Unit (IU) of AP was administrated into the vitreous cavity. After 15 to 30 minutes of incubation, the proliferative membrane was treated.
Results:
The proliferative membrane was removed successfully without iatrogenic retinal break. Complete reattachment of the posterior pole retina was achieved in all six eyes (100%). No obvious complication was observed in the follow-up period, which ranged from 11 to 14 months.
Conclusions:
These results suggest the benefit of AP in the vitrectomy for treatment of stage 5 ROP.
