Pioneering enzymatic vitreolysis treatment for floaters

A 2007 scientific publication recently came to our attention, "Posterior vitreous detachment and pharmacologic vitreolysis: The New Era of enzymatic vitrectomy"1. It talked about the use of plasmin, a protease from the patient's own blood, as an adjunct 15 minutes prior to surgical vitrectomy to induce posterior vitreous detachment.

Due to the potential effect any such drug may have on floaters, we requested an interview one of the article authors, Dr. Manuel Jose Diaz-Llopis, Professor of Ophthalmology and Head of Ophthalmology at Faith Hospital and the University of Valencia, Spain. He informed us that he has been performing the treatment over the past 18 months including on 20 patients whose only eye problem was vitreous opactities.

Interview

[This interview was originally conducted in Spanish]

Can you describe the treatment?

It consists of the administration of one to three injections similar to those performed in diabetics but with different composition and separated by 15 to 30 days. The patient is numbed with drops and can return home after the injection.

How does it work?

By liquefying the vitreous gel structure.

Has it been proven to be effective with miodesopsias?

The effectiveness varies. There is clinical satisfaction or a sense of clear improvement by the patient in 40% of cases.

Are there any risks or potential unwanted side effects?

There is the possibility of an inflammatory reaction and the risk of infection exists in any medical procedure. These do not usually occur, but patients should be given preventive treatment and post-injection.

Is there any data available as clinical studies or statistics about treatment?

It is available in English at this link. http://www.ncbi.nlm.nih.gov/pubmed?term=Diaz-Llopis%20plasmin

Is the treatment covered by Social Security?

Yes, it is covered by Spanish Social Security.

• 1. Díaz-Llopis, M., and E. Cervera. "[Posterior vitreous detachment and pharmacologic vitreolysis: the new age of enzymatic vitrectomy]." Arch Soc Esp Oftalmol. 82.8 (2007): 465-6.