Removal of traumatic cyclitic membranes: surgical technique and results

Abstract

As most patients with a history of open globe injury and judged to have cyclitic membrane are denied further surgery because of poor prognosis, a technique for creating radial cuts in traumatic cyclitic membranes and its results are described. This is a retrospective non-comparative interventional case series of eight eyes with history of penetrating eye injury with fibrovascular membrane over the pars plicata observed during vitrectomy. All eyes were hypotonic; two had undergone previous vitrectomy and had developed RD. During vitrectomy after penetrating trauma, lens and its capsule or IOL was removed, fibrovascular membrane was visualized over pars plicata with the aid of external compression and after removal of the center of anterior hyaloid face, radial cuts were placed over the membrane. The resulting pieces were removed with vitrectomy probe. An encircling buckling element was placed in all eyes. Best corrected visual acuity, IOP, and postoperative complications are described. Eight eyes of eight patients (F: 3, M: 5) with an age range of 2-22 years (median: 11.5) with traumatic cyclitic membranes treated with the above technique were included in the study. They were followed for 6-18 months (median: 12 months). Seven patients had visual acuity of light perception to hand motion before operation . Preoperative IOP was low in all eyes (2-5 mmHg, median: 4 mmHg). One eye with a history of large foreign body removal was finally visually lost due to PVR. The other eyes had visual acuity of more than 20/100 (more than 20/60 in six eyes) and a normal IOP (8-20 mmHg, median 11 mmHg) in the last visit. Placement of radial cuts over traumatic cyclitic membranes followed by removal of the pieces is well tolerated by the ciliary epithelium with good retaining of its secretory function and normalization of IOP.