Plasmin enzyme-assisted vitrectomy in traumatic pediatric macular holes
Plasmin enzyme-assisted vitrectomy in traumatic pediatric macular holes
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DOI：
10.1016/s0161-6420(98)99027-3
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发表时间：
1998-09-01
期刊：
影响因子：
13.7
通讯作者：
Ferrone, PJ
中科院分区：
文献类型：
--
作者：
Margherio, AR;Margherio, RR;Ferrone, PJ
目的：本研究旨在评价纤溶酶辅助黄斑裂孔手术治疗外伤性黄斑裂孔患儿的疗效。设计：1996年7月13日至1996年11月16日在William Beaumont医院手术的前瞻性非比较病例系列，观察至少6个月。参与者：在此期间，作者对连续4例14岁或以下的创伤性黄斑孔患者的4只眼睛进行了手术。干预措施：患者行纤溶酶辅助玻璃体平面肌切除伴膜剥离、液气交换、术后定位，使用的酶为0.4国际单位（IU）自体纤溶酶。主要观察指标：观察两组患者的视力改善情况，最终视力达到20/40及以上，术后并发症及再手术发生率。结果：4个黄斑孔均闭合成功。随访6 ~ 12个月。没有再手术。所有眼睛的视力从4线提高到8线。3只眼（75%）术后视力达到20/40或更好。3只眼（75%）有一过性、后侧、囊下白内障的发展：2只眼是手术后发生的，1只眼是最初损伤的结果。结论：纤溶酶辅助玻璃体切除、膜剥离、气液交换治疗小儿外伤性黄斑裂孔可使黄斑裂孔闭合，视力明显改善。
Objective: This study aimed to evaluate the benefit of plasmin enzyme-assisted macular hole surgery on a consecutive series of pediatric patients with traumatic macular holes.Design: Prospective noncomparative case series operated on at William Beaumont Hospital between July 13, 1996, and November 16, 1996, and observed for at least 6 months.Participants: During this interval, the authors operated on four eyes from four consecutive patients who were 14 years of age or younger with traumatic macular holes.Intervention: The patients underwent plasmin enzyme-assisted pars plana vitrectomy with membrane peeling, fluid-gas exchange, and postoperative positioning, The enzyme used was 0.4 international unit (IU) of autologous plasmin enzyme.Main Outcome Measures: Snellen lines of improvement in visual acuity and rate of final visual acuity of 20/40 or greater, and incidence of complications and reoperations were measured.Results: All four macular holes were closed successfully. Follow-up was from 6 to 12 months. There were no reoperations. Visual acuity improved from four to eight lines in all eyes. Three eyes (75%) achieved a postoperative visual acuity of 20/40 or better. Three eyes (75%) had transient, posterior, subcapsular cataracts develop: two of the eyes after surgery and one as a result of the initial injury.Conclusion: The treatment of pediatric traumatic macular holes with plasmin enzyme-assisted vitrectomy, membrane peeling, and gas-fluid exchange resulted in closure of the macular holes with significant visual improvement.