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VI.C. Pharmacologic Vitreolysis with Tissue Plasminogen Activator

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Vitreous

Abstract

In the late 1980s and early 1990s, it was assumed that vitrectomy is a perfect tool to handle most vitreoretinal diseases even in cases of vitreo-macular traction. However, vitrectomy surgery includes risks like retinal detachment, hemorrhages, cataract formation, and infections. To avoid these problems, there is a need for a pharmacologic approach called pharmacologic vitreolysis. Even though the use of enzymes in ophthalmology has a long history, some of these enzymes, like hyaluronidase [47] and collagenase [43], were investigated long before vitrectomy was introduced. Further investigations for liquefaction and posterior vitreous detachment since the beginning 1990s with different types of enzymes have been reported. Streptokinase [5], hyaluronidase [11, 3], nattokinase [60], and chondroitinase [12, 3, 58, 13] were investigated but had significant side effects or insufficient clinical efficacy.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Philipps-University, Marburg, Germany

    Peter Kroll MD

  2. Augenklinik der SLK-Kliniken, Am Gesundbrunnen 20-26, Heilbronn, 74076, Germany

    Lutz Hesse MD

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  1. Peter Kroll MD
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  2. Lutz Hesse MD
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Correspondence to Peter Kroll MD .

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Editors and Affiliations

  1. VMR Institute for Vitreous Macula Retina, Huntington Beach, California, USA

    J. Sebag

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Kroll, P., Hesse, L. (2014). VI.C. Pharmacologic Vitreolysis with Tissue Plasminogen Activator. In: Sebag, J. (eds) Vitreous. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1086-1_49

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  • DOI: https://doi.org/10.1007/978-1-4939-1086-1_49

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