Fibrin Membrane Pupillary-Block Glaucoma After Uneventful Cataract Surgery Treated With Nd: Yag Laser

Fibrin pupillary-block glaucoma is a rare complication after uneventful cataract surgery. There are various treatment protocols tried in the early stages of this complication. The first goal is to quickly reduce the intraocular pressure and create the anterior chamber depth. We aimed to share our treatment approach with Nd:YAG laser fibrin membranotomy.

We present a case of fibrin pupillary block glaucoma in a patient who was successfully treated with primary Nd:YAG laser.

A 68-year-old man, he does not have any sistemic  comorbidity developed acute elevation of intraocular pressure with a shallow anterior chamber seven days after uneventful cataract surgery. The patient was admitted to our hospital with the complaints of sudden onset of pain, redness and decreased vision in the operated eye. Right VA was 0.1 and IOP was 48 mmHg. Conjunctival obstruction was observed. Although it could not be evaluated definitively due to intense corneal edema, the anterior chamber depth was greatly reduced. There was a fibrin membrane that completely closed the pupillary distance and with 360 degrees of peripheral iridocorneal touch. An Nd:YAG laser was used to create an opening in the superior. margin of the membrane. Perforation of the membrane led to rapid deepening of the anterior chamber, permittng a sequential argon–Nd:YAG peripheral iridotomy to be performed at the same sitting. The IOP was 26 mmHg after these procedures.

Although the fibrin membrane seen after uneventful cataract surgeries usually suggests the presence of systemic diseases in which inflammation is triggered, these results can sometimes occur even before the disease is present.