In vivo generated autologous plasmin assisted vitrectomy in young patients

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Pathology

Background:

• Posterior vitreous detachment (PVD) induction is crucial in vitrectomy for young patients.
• Autologous plasmin enzyme aids PVD induction, but direct injection is challenging.
• In-vivo plasmin generation via tissue plasminogen activator (t-PA) and autologous whole blood (AWB) is a novel approach.

Purpose of the Study:

• To evaluate the efficacy of preoperative simultaneous intravitreal injection of t-PA and AWB.
• To assess the facilitation of intraoperative PVD induction in young patients.
• To report outcomes in patients with various vitreoretinal pathologies.

Main Methods:

• Retrospective review of 17 eyes from 16 young patients undergoing vitrectomy.
• Simultaneous intravitreal injection of 0.1 ml AWB and 25 µg t-PA administered 3 days prior to surgery.
• Outcome measures included PVD separation attempts, visual acuity, and complications.

Main Results:

• Successful intraoperative PVD separation was achieved in all cases (mean 2.86 attempts).
• Mean LogMAR visual acuity improved significantly from 1.38 preoperatively to 0.51 postoperatively (p < 0.001).
• No intraoperative or preoperative complications were reported.

Conclusions:

• Preoperative simultaneous intravitreal injection of t-PA and AWB effectively facilitates intraoperative PVD induction in young patients.
• This technique simplifies the surgical procedure and improves visual outcomes.
• The method is safe and efficient for managing vitreoretinal pathologies requiring vitrectomy.