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...
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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 |
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http://imj.galenos.com.tr/archives/archive-detail/article-preview/fibrin-membrane-pupillary-block-glaucoma-after-une/21017
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| author | Tülay Alpar Akçetin Kadir Eltutar Nurhan Dinçer Fatma Esin Özdemir |
| author_facet | Tülay Alpar Akçetin Kadir Eltutar Nurhan Dinçer Fatma Esin Özdemir |
| author_sort | Tülay Alpar Akçetin |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T13:11:28Z |
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| id | doaj.art-56c713caec2748d09c9ea7718f179482 |
| institution | Directory Open Access Journal |
| issn | 2619-9793 2148-094X |
| language | English |
| last_indexed | 2024-04-10T13:11:28Z |
| publishDate | 2015-03-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | İstanbul Medical Journal |
| spelling | doaj.art-56c713caec2748d09c9ea7718f1794822023-02-15T16:12:37ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2015-03-01161424410.5152/2015.9188613049054Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case ReportTülay Alpar Akçetin0Kadir Eltutar1Nurhan Dinçer2Fatma Esin Özdemir3 İstanbul Eğitim ve Araştırma Hastanesi, Göz Kliniği, İstanbul, Türkiye İstanbul Eğitim ve Araştırma Hastanesi, Göz Kliniği, İstanbul, Türkiye İstanbul Eğitim ve Araştırma Hastanesi, Göz Kliniği, İstanbul, Türkiye İstanbul Eğitim ve Araştırma Hastanesi, Göz Kliniği, İstanbul, Türkiye 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. http://imj.galenos.com.tr/archives/archive-detail/article-preview/fibrin-membrane-pupillary-block-glaucoma-after-une/21017 Fibrin membranepupillary block glaucomacataract surgeryultrasound biomicroscopytissue plasminogen activator |
| spellingShingle | Tülay Alpar Akçetin Kadir Eltutar Nurhan Dinçer Fatma Esin Özdemir Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report İstanbul Medical Journal Fibrin membrane pupillary block glaucoma cataract surgery ultrasound biomicroscopy tissue plasminogen activator |
| title | Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report |
| title_full | Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report |
| title_fullStr | Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report |
| title_full_unstemmed | Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report |
| title_short | Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated with Intracameral Tissue Plasminogen Activator: A Case Report |
| title_sort | fibrin membrane pupillary block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator a case report |
| topic | Fibrin membrane pupillary block glaucoma cataract surgery ultrasound biomicroscopy tissue plasminogen activator |
| url |
http://imj.galenos.com.tr/archives/archive-detail/article-preview/fibrin-membrane-pupillary-block-glaucoma-after-une/21017
|
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