Treatment approaches to postoperative fibrinoid syndrome after phacoemulsification

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BACKGROUND: Postoperative fibrinoid syndrome (PFS) is an early complication of phacoemulsification, manifested by fibrin deposition on the iris and the intraocular lens surface, which leads to visual acuity decrease.

AIM: To assess the rate and the treatment efficacy (by YAG laser, enzymatic, medicalmentous) in PFS after phacoemulsification.

MATERIALS AND METHODS: Retrospective analysis of 56,019 cataract surgery cases of 2017–2021. There were 49 patients with PFS divided into 3 groups according to treatment approaches: 1st group — medicamentous treatment (MT) + YAG laser destruction of the fibrin film (n = 6); 2nd — MT + prourokinase injection into the anterior chamber (n = 6); 3rd — MT only (n = 37).

RESULTS: There was no difference between groups in best-corrected visual acuity (BCVA) before the PFS development. There was a more rapid increase in BCVA in the 1st and the 2nd groups compared with the 3rd one on the third day (0.20 ± 0.09 and 0.21 ± 0.08 versus 0.09 ± 0.08 for groups respectively, p = 0.001) and on the fifth day of treatment (0.25 ± 0.10 and 0.27 ± 0.13 versus 0.16 ± 0.14, p = 0.029). Nevertheless, in one week, there was no difference in BCVA between groups. Unfortunately, BCVA did not return to baseline in any group.

CONCLUSION: The incidence of PFS after phacoemulsification is relatively low and amounts to 0.093%. The most rapid BCVA recovery was observed in the 1st and the 2nd groups.

作者简介

Dmitrii Belov

Saint Petersburg Multifield Hospital No. 2

编辑信件的主要联系方式.
Email: belovd1990@gmail.com
ORCID iD: 0000-0003-0776-4065
SPIN 代码: 2380-2273

MD, Cand. Sci. (Med.), Ophthalmologist

俄罗斯联邦, Saint Petersburg

Vladimir Petukhov

Saint Petersburg Multifield Hospital No. 2

Email: v.p.petukhov@gmail.com
ORCID iD: 0000-0003-4973-3937
SPIN 代码: 2879-9313

Ophthalmologist

俄罗斯联邦, Saint Petersburg

参考

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2. Fig. 1. Postoperative fibrinoid syndrome manifestations: fibrin depositions on the intraocular lens and iris surface spreading into the iridocorneal angle

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3. Fig. 2. Preserved red reflex from the funduspresence in the setting of fibrin exsudation ion

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4. Fig. 3. Irregular pupil as an outcome of postoperative fibrinoid syndrome

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5. Fig. 4. Best-corrected visual acuity dynamics due to treatment regimen

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