Anterior segment imaging in the management of postoperative fibrin pupillary–block glaucoma

Postoperative fibrin pupillary–block glaucoma, an uncommon complication of intraocular surgery, develops when an inflammatory fibrin membrane occludes the pupil, resulting in peripheral angle closure. We present a series of 4 patients with this condition and describe the role of anterior segment optical coherence tomography and ultrasound biomicroscopy in distinguishing fibrin pupillary–block glaucoma from other forms of postoperative acute glaucoma. Specific to this condition is the presence of a fibrin membrane across the pupil and accumulation of aqueous in the posterior chamber, as would be expected in pupil block, but with a clear separation between the intraocular lens and the iris. The possible risk factors are discussed and various treatment modalities reviewed.