Postoperative hypopyon after intravitreal bovine thrombin for macular hole surgery.
OBJECTIVE
We used intravitreal autologous fibrinogen with bovine thrombin for the surgical closure of macular holes in 60 cases.


METHODS
Pars plana vitrectomy with separation of the posterior cortical vitreous was performed after air/fluid exchange. One to two drops each of autologous fibrinogen and bovine thrombin (20 to 80 U) were instilled in each patient.


RESULTS
Five (8%) of 60 patients developed a hypopyon without unusual pain on the first postoperative day. Inflammation responded to frequent topical corticosteroids within 48 to 72 hours.


CONCLUSIONS
Postvitrectomy hypopyon after the use of bovine thrombin may represent an immune reaction that must be differentiated from endophthalmitis. We recommend careful observation and frequent topical corticosteroids.
Olsen
T W
TW
Department of Ophthalmology, Emory University, Atlanta, GA 30322, USA.
Sternberg
P
P
Martin
D F
DF
Capone
A
A
Lim
J I
JI
Aaberg
T M
TM
D000328:Adult; D000818:Animals; D000867:Anterior Chamber / Q000187:drug effects* / Q000473:pathology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002417:Cattle; D004359:Drug Therapy, Combination; D005340:Fibrinogen / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D012167:Retinal Perforations / Q000188:drug therapy* / Q000601:surgery; D013256:Steroids; D013492:Suppuration / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology; D013917:Thrombin / Q000009:adverse effects* / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D014821:Vitrectomy; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D013256:Steroids; D005340:Fibrinogen; D013917:Thrombin