Guys, I read that they have been several improvement in Enzymatic Vitrectomy recently. I post some articles in spanish and english to share...
As I see, there are some advances in Spain, Ireland, USA and Germany in Enzymatic Vitrectomy. In resume:
1. The are several products being probed to create controlled total PVD:
Dispase, hyaluronidase, condroitinase, plasminogen tissue activator, urokinase, streptokinase, natokinase, collagenase, plasmine and microplasmine.
Commercially studied are:
Natokinase (Subtisilin NAT®), hyaluronidase (Vitrase®) and microplasmine (Trombogenic®)
Of all three, the best promising is the microplasmine, because of its low mollecular mass makes them to to penetrate epiretinal tissue more effectively.
Hyaluronidase (Vitrase) is not a good solution as it not always make a complete detachment of vitreous.
You can found more information here (also there are trials still recruiting volunteers):
2004 - Posterior Vitreous Detachment Induced by Microplasmin http://www.iovs.org/cgi/reprint/45/2/641
Link to the Company that develops Microplasmin: http://www.thrombogenics.com/html/pipeline2A.asp
IMPORTANT: Link to the Trials being made by this company (STILL RECRUITING): http://www.clinicaltrials.gov/search/sponsor=ThromboGenics
2005 - Very Good Article with Lot of Information about Vitreous and Enzymatic Vitrectomy: http://www.aosonline.org/xactions/2005/1545-6110_v103_p473.pdf
2. RECENTLY NEWS. The most studied and probed solution is the "plasmine" isolated from the same patient serum
In 2007 the worst problem for this solution was the high cost, laborious and sophisticated praparation technique, needing elite hematology laboratorious.
But since then at least two new techniques has been developed to prepare the plasmin in a cheap and quick way in the same operating room.
From this two options, the use of streptokinase as enzyme plasmine activator seems to have some problems and possible posterior inflammation that does not happens when using UROKINASE.
2007 - POSTERIOR VITREOUS DETACHMENT AND PHARMACOLOGIC VITREOLYSIS: THE NEW AGE OF ENZYMATIC VITRECTOMY
2008 - Intravitreal autologous plasmin without associated-vitrectomy. Pharmacological vitreolysis, a perfeccionated method using urokinase
So, it seems that both "risk-not-free" Laser and Mechannical Vitrectomy are going soon to be changed with less invasive Famachological vitrectomies. Of course, although they have been experimenting in the last years, they need time to be known all their side-effects but seems to be much less perjudicial than with the actual solutions.
I remember you to check the TRIALS webpage, to see if there is a TRIAL of microplasmine near you.
Floaters Friends. Good night... and Good Luck ;-)