Intravitreal Plasmin Without Associated Vitrectomy as a Treatment for Refractory Diabetic Macular Edema

To determine the effectiveness of a low-dose intravitreal injection of autologous plasmin enzyme (APE), without the performance of a vitrectomy, as a treatment for refractory diffuse diabetic macular edema (DDME).Prospective, comparative, interventional case series.Sixteen patients with bilateral DDME who had not responded to prior laser photocoagulation. All patients received an injection in 1 eye, while the other eye served as a control.Intravitreal 0.2 mL APE injection under topical anesthesia. The APE was obtained using a simplified method.Central macular thickness (CMT) at 1 and 6 months, determined by optical coherence tomography (OCT) and best corrected visual acuity (BCVA).All patie…