Preliminary Efficacy of Autologous Plasmin Injection in Pediatric Vitrectomy

Purpose: To evaluate the efficacy of autologous plasmin in pediatric vitrectomy and to report the anatomic outcomes of autologous plasmin assisted pediatric vitrectomy Methods: In an interventional prospective study, Thirty-four pediatric patients with vitreoretinal disorders who needed vitrectomy during 2008 to 2010, included in the study. The patients were divided into two groups: the retinopathy of prematurity (ROP) and the other vitreoretinal disorders (non-ROP) groups. The patients underwent plasmin assisted vitrectomy. The anatomic outcome was studied among patients with ROP and rhegmatogenous retinal detachment (RRD). Grading of the induced posterior vitreous detachment (PVD) and intraoperative complications were reported by the surgeon. Follow-up examinations revealed anatomic outcomes and complications. The PVD was graded as 0-4 or questionable and anatomic outcomes was reported as total attachment, partial attachment, and detachment. Results: The mean age of patients was 21.82±31.94 months. Forty-four percent were male. Among the ROP group 82.3% had questionable PVD, 5.9% grade 2, 5.9% grade 3, and 5.9% grade 4; and among the non-ROP group: 12%, 12%, 23%, and 53% had grade 1, 2, 3, and 4 PVD, respectively (p<0.001). After 6 months follow-up, in ROP cases, 29.5% had total attachment, 47% partial attachment, and 23.5% detachment. Among RRD cases 100% had total attachment. No complications were seen during surgery. Conclusion: Intravitreal plasmin injection may facilitate the complete PVD induction with few complications and acceptable anatomic outcomes in pediatric vitreoretinal disorders.