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Fibrin membrane pupillary block after cataract surgery in a patient with diabetes

      A 52-year-old man with diabetes presented with a flat anterior chamber in the right eye on the 30th postoperative day after manual small-incision cataract surgery. His best-corrected visual acuity was 20/40. Slit-lamp examination (Fig. 1) showed clear cornea with a flat anterior chamber. Posterior chamber intraocular lens was in the bag and in position posteriorly. Fibrin membrane was seen attached to the pupillary margin, causing complete pupillary block. The finding was confirmed with an ultrasound biomicroscopy (Fig. 2). Intraocular pressure was 25 mm Hg. Immediate YAG peripheral iridotomy was done, which allowed deepening of the anterior chamber as shown in Figure 3. This was followed by YAG membranectomy.
      Figure 1
      Fig. 1Slit-lamp showing pupillary block caused by a thin inflammatory fibrin membrane.
      Figure 2
      Fig. 2Ultrasound biomicroscopy showing shallow anterior chamber and posterior chamber intraocular lens in position in the bag.
      Figure 3
      Fig. 3Ultrasound biomicroscopy showing deepening of the anterior chamber after YAG peripheral iridotomy with fibrin membrane still attached at the pupil.
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