Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report
<p>Abstract</p> <p>Background</p> <p>Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-03-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://www.biomedcentral.com/1471-2415/12/3 |
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| author | Yoshino Hideaki Seki Masaaki Ueda Jun Yoshino Takaiko Fukuchi Takeo Abe Haruki |
| author_facet | Yoshino Hideaki Seki Masaaki Ueda Jun Yoshino Takaiko Fukuchi Takeo Abe Haruki |
| author_sort | Yoshino Hideaki |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure.</p> <p>Case presentation</p> <p>A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block.</p> <p>Conclusion</p> <p>This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.</p> |
| first_indexed | 2024-12-17T05:12:56Z |
| format | Article |
| id | doaj.art-be8cf8eafd66424f90332036c382c657 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-17T05:12:56Z |
| publishDate | 2012-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-be8cf8eafd66424f90332036c382c6572022-12-21T22:02:12ZengBMCBMC Ophthalmology1471-24152012-03-01121310.1186/1471-2415-12-3Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case reportYoshino HideakiSeki MasaakiUeda JunYoshino TakaikoFukuchi TakeoAbe Haruki<p>Abstract</p> <p>Background</p> <p>Fibrin pupillary-block glaucoma is a rare complication after cataract surgery. The treatment for this condition is still controversial, since Nd:YAG laser fibrin membranotomy tends to reocclude and laser peripheral iridotomy entails the risk of damaging the corneal endothelium in the presence of corneal edema associated with elevated intraocular pressure.</p> <p>Case presentation</p> <p>A 62-year-old man with diabetes mellitus developed acute elevation of intraocular pressure with a shallow anterior chamber five days after uneventful cataract surgery. Initially, slit lamp examination provided only limited information due to severe corneal edema. After resolution of corneal edema with systemic glaucoma therapy, a complete fibrin membrane was observed across the pupil by slit lamp examination. Anterior segment optic coherence tomography clearly revealed a thin fibrin membrane covering the entire pupillary space, a shallow anterior chamber, and a deep posterior chamber. The intraocular lens was not observed by anterior segment optic coherence tomography. In contrast, ultrasound biomicroscopy, which has superior penetration depth, was able to visualize the intraocular lens deep in the posterior chamber. Injection of tissue plasminogen activator into the anterior chamber resulted in complete fibrinolysis and released the pupillary block.</p> <p>Conclusion</p> <p>This case suggests that ocular anterior segment imaging modalities, especially ultrasound biomicroscopy, serve as powerful diagnostic tools to identify mechanisms of acute angle closure glaucoma, which is often accompanied by poor intraocular visibility. This is the first reported case of fibrin pupillary-block glaucoma after cataract surgery successfully treated with intracameral tissue plasminogen activator.</p>http://www.biomedcentral.com/1471-2415/12/3Pupillary block glaucomaFibrin membraneCataract surgeryAnterior segment imagingTissue plasminogen activator |
| spellingShingle | Yoshino Hideaki Seki Masaaki Ueda Jun Yoshino Takaiko Fukuchi Takeo Abe Haruki Fibrin membrane pupillary-block glaucoma after uneventful cataract surgery treated with intracameral tissue plasminogen activator: a case report BMC Ophthalmology Pupillary block glaucoma Fibrin membrane Cataract surgery Anterior segment imaging 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 | Pupillary block glaucoma Fibrin membrane Cataract surgery Anterior segment imaging Tissue plasminogen activator |
| url | http://www.biomedcentral.com/1471-2415/12/3 |
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