Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Perzistentna pupilarna membrana (PPM) nastaje kod nedovoljne involucije i atrofije pupilarne membrane. Većina PPM ne traži nikakvo liječenje, jer samo rijetko uzrokuje pad vida. Tvrdokorne strukture membrane variraju od nekoliko nepigmentiranih tračaka do debele membrane koja prekriva cijelu zjenicu. Cilj je pokazati prednosti laserskog liječenja PPM kod kojih se planira fakoemulzifikacijska operacija katarakte. Opisuje se slučaj bolesnice s obostranom PPM i kataraktom, kod koje je nastupio znatan pad vida kod vanjskog svjetla na desnom oku i koja je liječena Nd-YAG laserom. Nakon laserske terapije i fakoemulzifikacije katarakte vid se poboljšao s 0,1 na 0,9 bez ikakvih komplikacija. Kao zaključak, ako se planira fakoemulzifikacija, prednost dajemo laserskoj terapiji PPM pred kirurškom ekscizijom PPM koja je udružena s komplikacijama poput infekcije, hifeme, rizika kod anestezije. Lasersko liječenje je relativno jednostavno, ugodnije od kirurškog, nakon zahvata je zjenica savršeno okrugla, što olakšava operaciju katarakte, a uz to se izbjegavaju intraoperacijska krvarenja tijekom kirurškog zahvata koja bi komplicirala fakoemulzifikaciju katarakte.Persistent pupillary membrane (PPM) is a consequence of incomplete involution and atrophy of the pupillary membrane. Most PPMs require no treatment because they rarely cause visual impairment. Remnant structures vary from a few non-pigmented threads to a thick membrane covering the entire pupil. The aim of this case report is to show the advantages of Nd-YAG laser lysis of PPM prior to phacoemulsification cataract surgery. We describe a case of a patient with bilateral PPM and cataract of the right eye having significant visual loss in bright light that underwent Nd-YAG laser lysis and experienced visual acuity improvement from 0.1 to 0.9 after phacoemulsification surgery, without any complications. We conclude that in PPM patients scheduled for cataract surgery, laser lysis of PPM prior to cataract surgery is preferable to surgical excision of PPM that is associated with complications such as infection, hyphema, and risk of anesthesia. Laser lysis of pupillary membranes is a relatively simple procedure. There is less discomfort than with surgical excision, and the procedure results in a perfectly round pupil, thus facilitating cataract surgery while also preventing intraoperative hemorrhage during surgical excision that may complicate the scheduled phacoemulsification cataract surgery
