| The Structure of the Internal Limiting Membrane Removed by Vitrectomy Using Tissue Plasminogen Activator. |
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Dong Su Kim, Sang Woong Moon, Seung Young Yu, Hyung Woo Kwak |
1Department of Ophthalmology, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea. Ophmoon@dreamwiz.com
2Department of Ophthalmology, Kyung Hee University Hospital, Seoul, Korea. |
| 조직플라스미노겐활성제를 이용한 유리체절제술시 제거된 내경계막의 구조 |
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김동수1ㆍ문상웅1ㆍ유승영2ㆍ곽형우2 |
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Department of Ophthalmology, Inje University College of Medicine, Seoul Paik Hospital1, Seoul, Korea / Department of Ophthalmology, Kyung Hee University Hospital2, Seoul, Korea |
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| Abstract |
PURPOSE
This study evaluated the effect of tissue plasminogen activator (TPA) on adhesion between the internal limiting membrane and the vitreous cortex in patients with diabetic macular edema. METHODS: This retrospective study included 14 eyes of 14 patients with diabetic macular edema without posterior vitreous detachment. The fourteen eyes were divided into two groups. In the first group, vitrectomy and internal limiting membrane (ILM) removal were performed after intravitreal TPA 0.1 cc (50 ug) injection the day before vitrectomy and in the second group, vitrectomy and ILM removal were performed without previous injection of TPA. We observed the ILM using electron microscopy and verified the effects of the TPA. RESULTS: Spontaneous posterior vitreous detachment occurred in 3 of 7 eyes in the first group. Internal limiting membranes removed by vitrectomy showed a smooth surface in 4 of 7 eyes in the first group and in 1 of 7 eyes in the second group. Seven eyes of the first group and 6 eyes of the second group revealed decreased foveal thickness and increased visual acuity 90 days postoperatively. CONCLUSIONS: Preoperative intravitreal TPA injection was helpful for achieving posterior vitreous detachment and for decreasing possible postoperative complications involving in remnant vitreous cortex in patients with diabetic macular edema. |
| Key Words:
Diabetic macular edema;Internal limiting membrane;Tissue plasminogen activator |
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