永存瞳孔膜治疗方法的选择

目的：探讨不同形态的永存瞳孔膜的治疗方法。

方法：选取永存瞳孔膜患者36例67眼。对于单条丝状永存瞳孔膜激光切除。单条粗大、网状或栅栏状瞳孔膜，在散瞳下应用激光脉冲击断残膜两端，然后采用透明角膜切口，注吸取出。膜状瞳孔膜行透明角膜切口，注入黏弹剂于残膜与晶状体前表面之间使其游离，用显微囊膜剪自瞳孔膜与虹膜连接处根部分别剪断，用囊膜镊取出。

结果：共治疗67眼，平均随访时间3.8a。54眼瞳孔区透明，无残膜遗迹，瞳孔圆形居中，对光反应灵敏。晶状体前囊色素残留者8眼，瞳孔欠圆者5眼。术后33眼眼压不同程度升高，治疗前后均差1.04kPa(4mmHg)，经降眼压治疗后恢复正常。无前房出血、误伤晶状体等其他并发症。

结论：对于单条丝状或条状不影响视功能的永存瞳孔膜，可采用激光治疗； 对于膜状或网状瞳孔膜，且影响患者的视功能发育者，手术是治疗该类瞳孔膜的有效方法。早期发现、早期治疗有利于患者获得有用视力，为部分弱视患者的视功能训练或合并眼底病患者的治疗提供有利条件。

Selection of treatment methods for persistent pupillary membrane

AIM:To explore the different forms of persistent pupillary membrane(PPM)treatment.

METHODS:For single filamentous PPM film laser excision. A single thick, reticular or palisade remnant film is applied to both ends of the broken membrane with a laser pulse under the pupil. The membrane-like remnant membrane is made of transparent corneal incision, which is free of residual membrane and lens surface by injecting viscoelastic agent.

RESULTS:The average follow-up time was 3.8a. Pupil area transparent, no residual membrane remains, pupil rounded center, sensitive to light, lens anterior capsule pigment residue 8 eyes, pupils are not round 5 eyes. The intraocular pressure of 33 eyes increased in varying degrees after operation, with a difference of 1.04kPa(4mmHg)before and after treatment and returned to normal after reduced intraocular pressure treatment. No anterior chamber bleeding, lens injury and other complications.

CONCLUSION:For PPM, which has a single filamentous or strip effect on visual function, is treated by laser. Severe membranous or reticular PPM affects the development of visual function in patients. Surgery is an effective method for the treatment of PPM. Early detection, early treatment is conducive to patients to obtain useful vision, for some patients with amblyopia visual function training, or combined with fundus disease treatment to provide favorable conditions.