Mehmet CANLEBLEBİCİ, Murat ERDAĞ, Mehmet BALBABA
Turkish Journal of Clinical and Experimental Ophthalmology - 2026;21(3):80-92
Purpose: To describe the clinical features, predisposing factors, and management strategies of postoperative fibrinous membrane formation following difficult cataract surgery in eyes without a history of uveitis or systemic rheumatologic disease. Materials and Methods: This case series included three patients who developed fibrinous anterior chamber reactions after phacoemulsification cataract surgery. None of the patients had a history of uveitis or systemic inflammatory disease. Detailed evaluation of systemic and ocular conditions, presence of risk factors were analyzed in relation to postoperative inflammatory outcomes. Results: All three cases developed clinically significant fibrinous reactions in the early postoperative period. Predisposing factors included diabetes mellitus in one patient, intraoperative floppy iris syndrome related to long-term tamsulosin use in one patient, and pseudoexfoliation syndrome in one patient. Two of the cases involved advanced cataracts, whereas the remaining case presented with senile nuclear cataract. Pupillary dilation was insufficient in one patient, while moderate pupillary dilation was observed in another. Despite uneventful surgeries, fibrinoid inflammation occurred, ranging from fibrin membranes to extensive posterior synechiae formation. Intensive topical corticosteroids and cycloplegic agents led to resolution of fibrinous membranes in all cases. One patient required surgical synechiolysis due to persistent posterior synechiae. Conclusion: Fibrinous membrane formation may occur after difficult cataract surgery even in non-uveitic eyes, particularly in the presence of diabetes mellitus, pseudoexfoliation syndrome, or intraoperative floppy iris syndrome. Careful preoperative risk assessment, early postoperative recognition, and prompt escalation of anti-inflammatory treatment are critical to prevent irreversible complications and achieve favorable visual outcomes.
