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| OPHTHALMIC IMAGES |
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| Year : 2021 | Volume
: 59
| Issue : 4 | Page : 411-412 |
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Fibrin membrane over intraocular lens (cocoon membrane)
D Bala Saraswathy, Kalpana Narendran
Department of Cataract Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| Date of Submission | 07-Feb-2021 |
| Date of Decision | 04-Jun-2021 |
| Date of Acceptance | 02-Jul-2021 |
| Date of Web Publication | 21-Dec-2021 |
Correspondence Address:
Dr. D Bala Saraswathy
Aravind Eye Hospital, Civil Aerodrome Post, Sitra, Coimbatore - 641 014, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/tjosr.tjosr_16_21
How to cite this article:
Saraswathy D B, Narendran K. Fibrin membrane over intraocular lens (cocoon membrane). TNOA J Ophthalmic Sci Res 2021;59:411-2 |
A 65-year-old male patient presented with complaints of redness and pain in the right eye 2 weeks postoperative period with no systemic illness. His best-corrected visual acuity was 6/9p. He had undergone uneventful small incision cataract surgery 2 weeks back for mature cataract. On slit-lamp examination, inflammatory fibrin membrane over polymethyl methacrylate intraocular lens (PMMA IOL), cocoon membrane, was noticed [Figure 1] and [Figure 2]. The anterior chamber was relatively quiet, and the patient was on topical antibiotic-steroid drops on tapering dose. Fundus examination was normal. He was given oral and topical stronger steroid drops for reducing the inflammation, and after 2 weeks, his inflammation over IOL subsided [Figure 3]. | Figure 1: Inflammatory or cocoon membrane covering the intraocular lens completely without involving pupillary border
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 | Figure 2: Enlarged picture showing fibrin deposits over intraocular lens
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 | Figure 3: Inflammatory membrane resolved after oral and topical steroid after 3 weeks
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Fibrinous membrane formation over IOL was found to be 7.6% of postcataract surgery cases due to blood ocular barrier breakdown and foreign body reaction in the eye.[1] It was observed that heparin-coated PMMA lens caused less inflammation than without heparin-coated lens.[2] Washing the IOL with balanced salt solution and reducing the exposure of IOL surface to the external environment before implantation into the eye reduces the chances of surface debris on the IOL, thus decreasing the inflammatory response to the IOL in early postoperative period.[3] Treatment is with steroids and spontaneous resolution within 2 weeks to 3 months.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initial will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Nishimura O. Fibrinous membrane formation over posterior chamber lens during the early postoperative period. Acta Ophthalmol 1994;72:21-6.  |
| 2. | Shah SM, Spalton DJ, Muir MK. Specular microscopy of the anterior intraocular lens surface. Eye (Lond) 1993;7 (Pt 5):707-10. |
| 3. | Davies NP, Rassam SR, Shah SM. Measurement of electrostatic charge on intraocular lenses. Eye (Lond) 1998;12 (Pt 3a):449-52. |
[Figure 1], [Figure 2], [Figure 3]
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