Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report
Objective: To evaluate the diagnostic and therapeutic methods of fibrindependent pupillary-block glaucoma (PBG).Methods: A 79-year-old male patient with hypertension was admitted to hospital with symptoms of pain and redness 6 days after an uneventful cataract surgery.Results: He had acute elevation...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2015-03-01
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| Series: | İstanbul Medical Journal |
| Subjects: | |
| Online Access: |
http://imj.galenos.com.tr/archives/archive-detail/article-preview/fibrin-membrane-pupillary-block-glaucoma-after-une/21017
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| Summary: | Objective: To evaluate the diagnostic and therapeutic methods of fibrindependent pupillary-block glaucoma (PBG).Methods: A 79-year-old male patient with hypertension was admitted to hospital with symptoms of pain and redness 6 days after an uneventful cataract surgery.Results: He had acute elevation of intraocular pressure with a shallow anterior chamber. Because of severe corneal edema, the anterior chamber details could not be distinguished. After systemic and topical antiglaucoma treatment, corneal edema was reduced and a complete fibrin membrane was observed across the pupil on slit lamp examination. A complete fibrin membrane across the pupillary space, shallow anterior chamber, and deep posterior chamber was confirmed by ultrasonic biomicroscopy (UBM). The intraocular lens (IOL) was actually displaced posteriorly, with a large clear space between the IOL and iris. Despite topical and subconjunctival corticosteroid therapy as well as Nd:YAG laser membranotomy, the fibrin membrane was not resolved. Tissue plasminogen activator (tPA) (25 μg) was injected intracamerally and the fibrin membrane was completely dissolved, improving the pupillar block.Conclusion: Anterior segment imaging techniques, especially UBM, are a powerful diagnostic technique for differentiating the technique for the analysis of the mechanisms underlying acute angle-closure glaucoma mechanism. Fibrin-dependent PBG was successfully treated with an intracameral injection of tPA. |
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| ISSN: | 2619-9793 2148-094X |