Abstract
Secondary glaucoma is a well-known complication post vitreoretinal surgery that is often difficult to manage. We report an unusual case of compressive angle crowding and fibrin induced pupillary block secondary to anterior segment ischemia following combined scleral buckle and vitrectomy surgery. Surgical removal of the fibrin membrane proved effective in reducing intraocular pressure and preventing glaucomatous damage to the optic disc.
Highlights
Secondary glaucoma post vitreoretinal surgery is often difficult to treat
Mechanisms of secondary glaucoma that have been described after vitreoretinal surgery include anterior segment ischemia and angle closure glaucoma from shallow detachment of the ciliary body, scleral indentation and compression of the vortex veins [1]
This article describes an unusual case of compressive angle crowding and fibrin induced pupil block secondary to anterior segment ischemia following combined scleral buckle and vitrectomy surgery that is well illustrated by anterior segment optical coherence tomography (ASOCT)
Summary
Secondary glaucoma post vitreoretinal surgery is often difficult to treat. Mechanisms of secondary glaucoma that have been described after vitreoretinal surgery include anterior segment ischemia and angle closure glaucoma from shallow detachment of the ciliary body, scleral indentation and compression of the vortex veins [1]. Mild cases may respond to topical antiglaucoma medications, in severe cases, releasing the buckle may be necessary. Glaucoma surgery with trabeculectomy or tube shunts is challenging due to significant conjunctival scarring. We illustrate unusual case of compressive angle crowding and fibrin induced pupil block secondary to anterior segment ischemia following combined scleral buckle and vitrectomy surgery. Our case is the first report of successful reduction of intraocular pressure after surgical removal of fibrin membrane without the need of topical antiglaucoma eye drops
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