Enzyme-Assisted Vitrectomy: An Update

The removal of epiretinal membranes and associated vitrectomy remains a hazardous undertaking even for the highly skilled surgeon equipped with advanced microinstrumentation. The use of a highly purified bacterial collagenase during vitrectomy represents a novel method of facilitating the removal of these dense fibrous membranes.1,2 Bacterial collagenase has been used clinically for debridement of decubitus ulcers3 and dermal burns.4 A highly purified form of the enzyme has been used for intravertebral discolysis, both experimentally and clinically.5 Animal toxicity studies, using electron microscopy and electroretinography, have shown no adverse effects on retinal components when the enzyme is intraocularly administered and allowed to incubate before its removal by the standard irrigation/aspiration process of vitrectomy.1