Plasmin enzyme-assisted vitreoretinal surgery in congenital X-linked retinoschisis: surgical techniques based on a new classification system

Retina. 2007 Oct;27(8):1079-85. doi: 10.1097/IAE.0b013e31806196d0.

Abstract

Purpose: To review the surgical outcome of autologous plasmin enzyme-assisted vitreoretinal surgery in managing complications associated with congenital X-linked retinoschisis (CXLRS).

Methods: Medical records of 20 patients (22 eyes) with CXLRS complications, treated with autologous plasmin enzyme-assisted vitreoretinal surgery, were reviewed. Surgical techniques were adapted according to a new CXLRS classification.

Results: Median age of the cohort was 3.5 years. Indications for surgical intervention included 8 eyes with schisis involving or threatening the macula, 7 eyes with rhegmatogenous retinal detachment, 4 eyes with tractional retinal detachment, 1 eye with vitreous and intraschisis hemorrhage, 1 eye with obstruction of the macula by an overhanging bullous schisis cavity, and 1 eye with macular pucker. Ninety-one percent (20/22) of eyes had retinal attachment postoperatively after an average of 1.3 procedures per eye. Of the eyes in which visual acuity was measured, 53% (8/15) improved, 33% (5/15) had no change, and 13% (2/15) lost vision.

Conclusion: Plasmin enzyme-assisted vitreoretinal surgery is a safe and effective method for managing the complications associated with CXLRS. Most patients had improved or stable postoperative visions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Fibrinolysin / therapeutic use*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retinal Detachment / etiology
  • Retinal Detachment / therapy*
  • Retinoschisis / classification*
  • Retinoschisis / complications
  • Retinoschisis / therapy*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity
  • Vitrectomy / methods*
  • Vitreous Hemorrhage / etiology
  • Vitreous Hemorrhage / therapy*

Substances

  • Fibrinolytic Agents
  • Fibrinolysin