Peeling the Persistent Pupillary Membrane.

A 6-year girl of Indian ethnicity was referred for poor vision. Examination showed bilateral persistent pupillary membrane covering the central pupil. When pupil was dilated, iris strands were connecting the central 1.5 mm diameter circular membrane with the pupillary margins (Figure 1). Homatropine 2% eye drops, 12-hourly, and spectacle correction of astigmatism failed to improve acuities better than 6/24. At surgery, viscoelastic (Healon GV) was injected to fill the anterior chamber and under the pupillary margin to separate parts of membrane and strands from the underlying crystalline lens. Twenty gauge vitreoretinal (end gripping, internal limiting membrane peeling) forceps was used to peel off the rest of the central membrane from the lens. Most of the membrane and the strands were easily removed, clearing the visual axis. To avoid damage to the lens capsule, minimum dissection was done and a few remaining strands and margins of circular membrane were left, expecting that these would not interfere with the vision.