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Plasmin Enzyme-Assisted Vitrectomy in Pediatric Patients with Vitreoretinal Diseases
Yung-Sung Lee1, Nan-Kai Wang, Yen-Po Chen
1Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Insights
Plasmin-assisted vitrectomy effectively induces posterior vitreous detachment in pediatric patients with vitreoretinal diseases, achieving good anatomical success and visual improvement with minimal complications.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Retina
Background:
- Pediatric vitreoretinal diseases present unique surgical challenges.
- Inducing posterior vitreous detachment (PVD) is crucial for successful vitrectomy.
- Minimally invasive techniques are desirable in pediatric surgery.
Purpose of the Study:
- To evaluate the efficacy and safety of plasmin-assisted vitrectomy.
- To assess the ability to achieve PVD using low suction power.
- To analyze outcomes in pediatric patients with various vitreoretinal conditions.
Main Methods:
- Prospective study of 11 pediatric patients (age ≤16 years) with vitreoretinopathies.
- Plasmin-assisted vitrectomy performed between 2012 and 2013.
- Primary outcome: induction of PVD with suction ≤200 mm Hg.
Main Results:
- PVD achieved in 100% of cases using low suction (mean 150 ± 39 mm Hg).
- Anatomical success in 73% of eyes; visual acuity improved in all measurable cases at 6 months.
- Complications included cataracts (36%) and transient intraocular pressure rise (9%).
Conclusions:
- Plasmin-assisted vitrectomy is an effective method for pediatric vitreoretinal surgery.
- The technique facilitates PVD induction with reduced surgical trauma.
- It offers a viable treatment option for diverse pediatric vitreoretinal pathologies.
Purpose:
To evaluate the efficacy and safety of using plasmin-assisted vitrectomy in pediatric patients with vitreoretinal diseases.
Methods:
We prospectively recruited children aged 16 years or younger who presented with vitreoretinopathies and underwent plasmin-assisted vitrectomy between 2012 and 2013. The main outcome measure was the induction of posterior vitreous detachment (PVD) using a suction power of 200 mm Hg or less during surgery.
Results:
Eleven eyes of 11 patients (mean age: 3.7 years; average follow-up duration: 14.1 months) were included. Of these 11 patients, there were 3 (27%) cases of stage 5 retinopathy of prematurity, 2 (18%) cases of persistent fetal vasculature, 2 (18%) cases of rhegmatogenous retinal detachment, 2 (18%) cases of idiopathic epiretinal membrane, 1 (9%) case of traumatic macular pucker, and 1 (9%) case of traumatic vitreous hemorrhage (9%). PVD was achieved in all cases (100%) during surgery using low suction after plasmin treatment (mean: 150 ± 39 mm Hg; range: 100-200). Overall, anatomical success was achieved in 8 eyes (73%). Visual acuity improved in all 5 (100%) patients for whom vision could be measured at 6 months after the operation. Cataracts were found in 4 eyes (36%), and a rise in transient intraocular pressure was observed in 1 eye (9%).
Conclusions:
Plasmin-assisted vitrectomy offers an effective and less traumatic intervention for a variety of pediatric vitreoretinal diseases.
