All Persistent Pupillary Membranes need not be treated - A case report

Persistent Pupillary Membrane is a common congenital anomaly which appears as a dense network of tissue across the pupil. It is usually asymptomatic, although blurring of vision can be seen in extensive conditions. This is a hospital based case study of an eleven year old girl with bilateral Persistent Pupillary Membrane since birth. The aim of the study is to establish that the treatment approach varies specific to the individual case and when asymptomatic, it can be safely left untreated as in the present study. Surgical Membranectomy, Pupilloplasty, Argon Laser Photocoagulation are the treatment options that can be considered in case of symptomatic conditions.

A rare case of persistent pupillary membrane: Case-based approach and management

Persistent pupillary membranes (PPMs) are a common congenital anomaly seen in 95% of neonates. Extensive PPMs, occluding the visual axis and resulting in reduced visual acuity, are relatively uncommon. We describe a case of bilateral total PPM in a 36-year-old female who presented with complaints of blurred vision in both the eyes. Dense pupillary membranes obscuring the visual axis need early surgical treatment. It is essential that the lens status remains clear along the visual axis both before and after pupilloplasty.

Surgical treatment for persistent pupillary membranes / 中南大学学报(医学版)

Objective:To explore surgical treatment for persistent pupillary membrane (PPM) and its effect.Methods:The medical records and postoperative follow-up data for 12 consecutive patients (16 eyes),who were submitted to PPM resection in Xiangya Hospital,Central South University from March 2011 to August 2016,were retrospectively reviewed.Results:Among 12 consecutive patients (16 eyes),8 patients (12 eyes) with PPM and clear lens were submitted to simply PPM resection,and 4 patients (4 eyes) with PPM and cataract were submitted to PPM resection combined with cataract surgery.In the patients who received the combined operation,phacoaspiration with or without intraocular lens implantation was performed in 3 eyes or in 1 eye.In the early stage after surgery,1 eye was complicated with a transient high intraocular pressure.In the patients who were submitted to PPM resection,the final follow-up visual acuity in 7 patients (11 eyes) were improved except 1 patient (1 eye).After the PPM resection combined with cataract surgery,the follow-up visual acuity was improved in 2 patients (2 eyes) but not in the other 2 patients (2 eyes).Conclusion:The surgical treatment is effect on congenital pupil residual membrane.Serious membrane pupil residual membrane should be surgically treated at early stage,and amblyopia treatment after the surgery is important.

Long-term Lens Complications Following Removal of Persistent Pupillary Membrane

PURPOSE: We evaluated the long-term surgical outcome and lens complications in children with persistent pupillary membrane following removal using vitreous scissors. METHODS: Patients diagnosed with persistent pupillary membrane who received surgical treatment from 1987 to 2012 were retrospectively reviewed. The removal was performed using vitreous scissors after instillation of miotics. The minimum follow-up period after surgery was four years. Factors of age, sex, visual acuity, refractive errors, and complications during or after surgery were evaluated. RESULTS: A total of 32 eyes of 26 patients were included. The mean age at the initial visit was 22.6 ± 34.7 (range, 0.9 to 141.2) months, and the mean age at surgery was 43.7 ± 36.0 (range, 1.0 to 142.5) months. There were no intraoperative complications using vitreous scissors, and all lesions were completely removed. After a mean follow-up period of 6.5 ± 3.3 (range, 4.0 to 14.8) years, the best corrected visual acuity at the final visit was 0.6 ± 0.9 logarithm of the minimum angle of resolution, and two eyes (6.3%) presented with lens opacity during follow-up. CONCLUSIONS: In children with persistent pupillary membrane, there were no intraoperative complications, and only two patients presented with lens change during the long-term postoperative follow-up period. Surgical removal should be considered a safe and effective treatment for patients with visually significant persistent pupillary membrane.

Results of Surgical Treatment for the Children with Persistent Pupillary Membrane

PURPOSE: To evaluate the long-term results of surgical treatment for the children with persistent pupillary membrane. METHOD: A retrospective study comprised of 12 eyes of 11 Korean patients who underwent surgical removal of persistent pupillary membrane who could be followed up beyond 4 years of age, excluding eyes with any other vision-affecting ocular anomalies. The preoperative and final visual acuity, age at surgery, final refractive status, surgical complication and combined ocular abnormality were reviewed. Mean visual acuity was calculated using logarithm of minimum angle of resolution (logMAR). RESULTS: Mean final BCVA was 20/257 (logMAR 1.11+/-0.68) in the unilateral 5 eyes and 20/33 (logMAR 0.22+/-0.25) in the bilateral 7 eyes, and there was significant difference (p=0.03). Of the 12 eyes, five eyes were under 0.3 at the last follow-up. Four eyes were unilateral (deprivation amblyopia) and one eye was bilateral (anisometropic amblyopia). Significant anisometropia was found in 7 of the 11 patients. One mild capsular opacity occurred as a postoperative complication. CONCLUSIONS: The visual prognoses for eyes with surgically removed persistent pupillary membranes were relatively good if they were bilateral. However, they showed poor visual outcome if they were unilateral in this study, so the early surgical intervention and aggressive management will be helpful if the persistent pupillary membrane is unilateral. Close follow-up with evaluation of visual acuity and refractive status is mandatory because this condition can lead to deprivation amblyopia and anisometropic amblyopia.

Surgical management for persistent pupillary membrane with vitreous scissors

Persistent pupillary membranes are common congenital disorders. To reduce the surgical complications, we used vitreous scissors instead of conventionally used Vannas scissors to remove the membrane and reviewed the surgical results. Five eyes of 4 children with persistent pupillary membrane were treated by surgery. Through the 1.5 mm limbal incision, the membrane was removed by using vitreous scissors after intracameral sodium hyaluronate. After 22.6 months follow-up, all pupils of operated eyes were round and no complications associated with the surgery were found. Three eyes showed improved visual acuities after the operation. We suggest that the surgery with vitreous scissors is better than with Vannas scissors.