Surgical membranectomy with modified incision and capsulotomy microscissors for persistent pupillary membrane

Ann Palliat Med. 2021 May;10(5):5619-5626. doi: 10.21037/apm-21-995.

Abstract

Background: To evaluate the visual outcome and complications of surgical membranectomy with modified incision and capsulotomy microscissors in patients with persistent pupillary membrane (PPM).

Methods: We enrolled eight eyes with PPM in six patients and performed surgical membranectomy with modified incision located near the limbus and corresponding to the middle of the densest membrane strands. Strands near the collarette of the iris were then cut using capsulotomy microscissors and thick strands were removed with capculorhexis forceps. Complications during or after surgery were evaluated, and uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) were compared pre- and post-surgery.

Results: The mean age of the patients at surgery was 9.5±3.4 years (range, 5.3 to 13.8 years). Bilateral PPMs were found in two patients, small anterior capsular cataracts not locating on the visual axis in three eyes, and deprivational amblyopia in four eyes. There were no traumatic cataracts, endophthalmitis, corneal opacities, or other complications in patients during or after modified surgical membranectomy. After a mean follow-up period of 5.8±0.4 (range, 5.0 to 6.0) months, UCVA was significantly improved from 0.23±0.14 to 0.36±0.20(P=0.026), and BCVA was also significantly improved from 0.32±0.22 pre-operatively to 0.56±0.25 post-operatively (P=0.006).

Conclusions: Surgical membranectomy with modified incision and capsulotomy microscissors may be a safe approach to clear the visual axis of patients with PPM. However further treatments were needed in amblyopic eyes after surgery.

Keywords: Membranectomy; capsulotomy microscissors; modified incision; persistent pupillary membrane.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Humans
  • Iris*
  • Postoperative Complications*
  • Treatment Outcome
  • Visual Acuity