Wu Wei-Chi, Drenser Kimberly A, Trese Michael T, Williams George A, Capone Antonio
Associated Retinal Consultants, PC, Royal Oak, Michigan 48073, USA.
Am J Ophthalmol. 2007 Nov;144(5):668-672. doi: 10.1016/j.ajo.2007.07.027. Epub 2007 Sep 17.
To review our experience with plasmin-assisted vitrectomy surgery for the treatment of pediatric macular holes.
Retrospective, interventional case series.
Thirteen pediatric patients aged one to 15 years with a traumatic macular hole underwent surgical repair. All patients underwent surgery between February 1997 and March 2005 with autologous plasmin enzyme-assisted vitrectomy. After induction of posterior vitreous detachment (PVD), vitrectomy with membrane peeling and gas or silicone oil injection were performed followed by prone positioning for seven days. Main outcome measures included anatomic closure rate, visual outcome, and ocular complications.
The macular hole was closed successfully in 12 (92%) of 13 cases. Of the 12 patients for whom vision could be measured, 11 patients (92%) had visual acuity improvement of 2 or more lines and six patients (50%) achieved vision of 20/50 or better; all of the patients achieved vision better than 20/200. The visual improvement was statistically significant (P = .005, Wilcoxon signed-rank test). Surgical complications included cataract formation in one patient and retinal detachment in one patient.
Autologous plasmin enzyme may be a helpful adjunct when performing vitrectomy for traumatic macular holes.
回顾我们使用纤溶酶辅助玻璃体切除术治疗儿童黄斑裂孔的经验。
回顾性介入病例系列。
13例年龄在1至15岁的患有外伤性黄斑裂孔的儿童患者接受了手术修复。所有患者在1997年2月至2005年3月期间接受了自体纤溶酶辅助玻璃体切除术。在诱导玻璃体后脱离（PVD）后，进行玻璃体切除术、剥膜以及气体或硅油注入，随后俯卧位7天。主要观察指标包括解剖学闭合率、视力结果和眼部并发症。
13例患者中有12例（92%）黄斑裂孔成功闭合。在12例可测量视力的患者中，11例（92%）视力提高了2行或更多行，6例（50%）视力达到20/50或更好；所有患者视力均优于20/200。视力改善具有统计学意义（P = .005，Wilcoxon符号秩检验）。手术并发症包括1例患者发生白内障，1例患者发生视网膜脱离。
在进行外伤性黄斑裂孔玻璃体切除术时，自体纤溶酶可能是一种有用的辅助手段。
