fibrin and Iris-Diseases

A 79-year-old female with rheumatoid arthritis suffered from severe induced iritis with dense fibrinous pupillary membrane occlusion and high intraocular pressure (57 mmHg) following cataract surgery. We used a Nd:YAG laser technique to dissect and move the dense pupillary membrane away and avoid invasive surgical procedures. Postoperatively, we recorded IOP 14 mmHg and visual acuity 20/30.

Topics: Aged; Cataract Extraction; Female; Fibrin; Follow-Up Studies; Humans; Intraocular Pressure; Iris; Iris Diseases; Laser Therapy; Membranes; Reoperation; Visual Acuity

Topics: Female; Fibrin; Humans; Iris Diseases; Laser Therapy; Membranes; Plasminogen Activators; Postoperative Complications; Pupil; Thrombolytic Therapy; Tissue Plasminogen Activator

Topics: Epithelium; Fibrin; Humans; Iris Diseases; Lenses, Intraocular; Membranes

We injected 25 micrograms of recombinant tissue plasminogen activator into the anterior chamber or the vitreous cavity in seven aphakic patients for pupillary block caused by a complete fibrin pupillary membrane that formed after vitrectomy with fluid-gas exchange. Progressive fibrin deposition resulted in pupillary block by three days after vitrectomy surgery in six patients, and seven days after vitrectomy in one patient. The pupillary block was associated with increased intraocular pressure in six patients. Tissue plasminogen activator was injected via the corneoscleral limbus in five patients and via the pars plana in two patients. In all patients, injection of tissue plasminogen activator resulted in complete fibrinolysis of the fibrin pupillary membrane within four hours, associated with a deepening of the anterior chamber. In the six patients with increased intraocular pressure at the time of tissue plasminogen activator injection, dissolution of the fibrin membrane was associated with a decrease in pressure. In all patients, intraocular pressure had returned to normal by three days after the injection. No complications were associated with the injection.

Topics: Adult; Aged; Anterior Chamber; Female; Fibrin; Humans; Insufflation; Intraocular Pressure; Iris Diseases; Male; Middle Aged; Recombinant Proteins; Retinal Detachment; Tissue Plasminogen Activator; Vitrectomy; Vitreous Body; Vitreous Hemorrhage

After pars plana vitrectomy and fluid-gas exchange, two patients developed fibrin membranes across the pupillary space resulting in pupillary block and subsequent glaucoma. In one case the angle was closed; in the second case the angle was open because of gas in the anterior chamber. In both cases the argon laser made permanent openings in the fibrin pupillary membrane that relieved the pupillary block.

Topics: Adult; Aged; Exudates and Transudates; Female; Fibrin; Gases; Glaucoma; Humans; Injections; Iris Diseases; Laser Therapy; Male; Vitrectomy; Vitreous Body

Topics: Anterior Chamber; Fibrin; Humans; Hyaluronic Acid; Iris Diseases; Laser Therapy; Lens Subluxation; Microsurgery; Prolapse; Surgical Instruments; Tissue Adhesives; Uveal Diseases; Yttrium

Two hundred eighty consecutive vitrectomies in diabetic patients were studied retrospectively. In 15 eyes, interlacing fibrin-like strands appeared on the surface of the retina and behind the iris plane from two to 14 days postoperatively. One or two days later, a gelatinous mass formed in the center of the vitreous activity, leading to the development of tractional retinal detachment and rubeosis iridis with neovascular glaucoma. Large doses of systemic and topical corticosteroids reversed the fulminating course of this complication in six of 15 eyes. The combination of lens surgery or scleral buckling procedure with vitrectomy, and the presence of retinal detachment preoperatively seemed to predispose to this complication. It is possible that multiple surgical procedures performed during the same operation cause an increase in vascular permeability resulting in the formation of a gelatinous, fibrin-like material in the diabetic eye.

Topics: Adult; Aged; Diabetic Retinopathy; Eye Diseases; Female; Fibrin; Glaucoma; Humans; Intraocular Pressure; Iris Diseases; Male; Middle Aged; Postoperative Complications; Retinal Detachment; Retrospective Studies; Syndrome; Vitreous Body