Chen Wan, Chen Kexin, Chen Hui, Wang Qiwei, Lin Duoru, Qin Tingfeng, Bai Bingyu, Lin Zhuoling, Li Jing, Li Xiaoyan, Lin Xiaoshan, Zhong Qiuping, Chen Weirong
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China .
J Cataract Refract Surg. 2024 May 1;50(5):511-517. doi: 10.1097/j.jcrs.0000000000001393.
To characterize the morphology of persistent pupillary membranes (PPMs) in pediatric patients and explore the corresponding surgical approaches.
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Prospective observational study.
Consecutive pediatric patients with PPMs who underwent surgery from April 2020 to July 2022 were included. PPM morphology was assessed and categorized according to its anatomic relationship with crystalline lens and distribution of iris strands. The surgical approaches for different morphologies of PPMs were described in detail. The visual outcome and operation-related complications were recorded.
31 eyes from 19 patients were included with the mean age of 7.2 years. 3 morphological variants of PPMs were observed: type I (51.6%, 16/31), a spider-like appearance and no adhesion to the anterior lens capsule (ALC); type II (38.7%, 12/31), a loose central adherence to the ALC and partially thick iris strands attached to the iris collarette; type III (9.7%, 3/31), a tight central adherence to the ALC and only silk-like iris strands. Surgeries were performed with a natural pupil size in type I, while dilated pupil in the other types. The adhesions between PPM and the ALC were separated by viscoelastic injection in type II and by discission needles in type III. The corrected distance visual acuity was significantly improved from 0.34 ± 0.18 logMAR preoperatively to 0.17 ± 0.09 logMAR postoperatively ( P < .001). No operation-related complications were observed during 9.5-month follow-up.
PPMs were categorized into 3 types according to their different morphologies, which helped to determine the best surgical strategy.
描述小儿患者持续性瞳孔膜（PPM）的形态，并探索相应的手术方法。
中国广州中山大学中山眼科中心。
前瞻性观察研究。
纳入2020年4月至2022年7月接受手术的连续性小儿PPM患者。根据PPM与晶状体的解剖关系及虹膜条索分布对其形态进行评估和分类。详细描述不同形态PPM的手术方法。记录视力结果及手术相关并发症。
纳入19例患者的31只眼，平均年龄7.2岁。观察到PPM的3种形态变异：I型（51.6%，16/31），呈蜘蛛样外观，与晶状体前囊无粘连；II型（38.7%，12/31），与晶状体前囊中央疏松粘连，部分粗大虹膜条索附着于虹膜小环；III型（9.7%，3/31），与晶状体前囊中央紧密粘连，仅有丝状虹膜条索。I型手术时保持自然瞳孔大小，其他类型则散瞳。II型通过粘弹剂注射分离PPM与晶状体前囊的粘连，III型用截囊针分离。矫正远视力从术前的0.34±0.18 logMAR显著提高至术后的0.17±0.09 logMAR（P<.001）。在9.5个月的随访期间未观察到手术相关并发症。
PPM根据其不同形态分为3型，这有助于确定最佳手术策略。
