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Postoperative hypopyon after intravitreal bovine thrombin for macular hole surgery
T W Olsen1, P Sternberg, D F Martin
1Department of Ophthalmology, Emory University, Atlanta, GA 30322, USA.
Purpose:
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.
Conclusion:
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.