Postoperative Fibrin Reaction and Descemet Membrane Detachment: A Case Report

• Published in: İstanbul Medical Journal Vol. 20; no. 2; pp. 165 - 168
• Main Authors: Alıkma, Mustafa Suat, Ünsal, Erkan, Akçetin, Tülay, Çubuk, Mehmet Özgür, Eltutar, Kadir
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi 01-03-2019
• Subjects: Descemet membrane detachment; fibrin reaction; phacoemulsification; tPA
• ISSN: 2619-9793; 2148-094X
• DOI: 10.4274/imj.galenos.2018.76992

An 85-year-old male patient who underwent phacoemulsification and intraocular lens implantation surgery in the right eye one week ago was admitted to our clinic for first week control. The patient stated that his vision had decreased slowly from post-operative day 1. Anterior segment examination revealed corneal edema, wrinkle in Descemet membrane, anterior chamber fibrin reaction and pseudophakic in the right eye. The left eye was phakic. Visual acuity (VA) was counting fingers at 3 meters in the right and 0.1 in the left eye. Intraocular pressure (IOP) was 14 mmHg in both right and left eyes. In the fundus examination, the right retina could not be evaluated clearly. In ultrasonography examination, the right retina was attached. Fundus examination of the left eye was normal. In the patient’s recorded notes on postoperative day 1, VA of the right eye was 0.4 and IOP was 14 mmHg, and the anterior segment examination revealed clear cornea and quiet anterior chamber. In the postoperative first week, 25 μg/mL 0.1 cc tissue plasminogen activator injection was performed due to fibrin reaction in the anterior chamber. As wrinkle in Descemet membrane and corneal edema persisted despite the regression of fibrin one day after injection, anterior segment optical coherence tomography (OCT) was performed for suspected Descemet membrane detachment. Total Descemet membrane detachment was observed in OCT. Sulfur hexafluoride (SF6) was injected into the anterior chamber to treat Descemet membrane detachment. It was observed that corneal edema and keratic stria disappeared, VA increased to 0.3, IOP was 14 mmHg, cornea was clear, there was gas in the anterior chamber and the fibrin was completely regressed on the first day after SF6 injection. In this study, we aimed to present a case with total Descemet membrane detachment with accompanying postoperative fibrin membrane and our successful treatment.