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  • Topical dilation as first-line treatment for fibrin membrane pupillary-block glaucoma following uncomplicated cataract surgery

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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Topical dilation as first-line treatment for fibrin membrane pupillary-block glaucoma following uncomplicated cataract surgery
  1. Sashia Bennett,
  2. Anne Studsgaard and
  3. Niklas Telinius
  1. Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Dr Sashia Bennett; sashiabbennett{at}gmail.com

Abstract

Fibrin membrane pupillary-block glaucoma is an uncommon complication after phacoemulsification cataract surgery. We present a case treated successfully by pharmacological dilation of the pupil. Previous case reports have recommended the use of Nd:YAG peripheral iridotomy, Nd:YAG membranotomy and intracameral tissue plasminogen activator.

The patient presented with intraocular pressure (IOP) of 45 mmHg 2 days after uneventful phacoemulsification cataract surgery. Anterior segment optical coherence tomography revealed that a fibrinous membrane-filled space had formed between the pupillary plane and the implanted intraocular lens.

The diagnosis of fibrin membrane pupillary-block glaucoma was made. Initial treatment consisted of IOP-lowering medication and topical pupillary dilation (atropine 1%, phenylephrine hydrochloride 10% and tropicamide 1%). Within 30 min, the dilation broke the pupillary block and the IOP was 15 mmHg. The inflammation was treated with topical dexamethasone, nepafenac and tobramycin. Within a month, the patient reached a visual acuity of 1.0.

  • Ophthalmology
  • Anterior chamber
  • Glaucoma

http://dx.doi.org/10.1136/bcr-2022-252693

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    Footnotes

    • Contributors All three authors examined the patient on several occasions and take full responsibility for the manuscript. SB drafted the manuscript. AS and NT reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.