Surgical Management of Congenital Pupillary-Iris-Lens Membrane

Abstract

Purpose

To describe the surgical interventions in congenital pupillary-iris-lens membrane. Six patients with congenital pupillary-iris-lens membrane presented with partial or totally occluded pupils, or increased intraocular pressure (IOP).

Methods

We describe the value of creating 2 paracenteses. The first one is made in the lower temporal quadrant and accommodates a 20-gauge anterior chamber maintainer (ACM). The second paracentesis is made in an upper quadrant and serves to cut the membrane with a vitrectomy probe.

Results

The technique was performed in 6 eyes of 6 children aged 4 to 10 months from March 2007 to July 2008 at Southwest Eye Hospital. These patients had congenital pupillary-iris-lens membrane with partial or totally occluded pupils, or increased IOP due to iris bombe or angle closure. No secondary glaucoma has been detected in the follow-up period. The visual acuity before the operations was less than 0.05 with preferential looking (PL), while the visual acuity was improved to 0.5 in 4 out of 6 eyes and 0.3 in 2 eyes in the last follow-up.

Conclusions

The ACM and vitrectomy probe are important tools in the surgical management of congenital pupillary-iris-lens membrane because they facilitate the surgical procedure and reduce iatrogenic damage to the lens. Timely surgical intervention can abort the progressive pupillary occlusion or angle closure glaucoma.