First Author: S. R.Singh INDIA
Co Author(s): S. Handa M. Dogra P. Bajgai B. Tigari R. Singh
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Cyclitic membrane is an important cause of chronic hypotony in cases of uveitis, especially in the pediatric age group. If left alone, it can lead to decreased visual function, sometimes even phthisis. We demonstrate the surgical technique to adequately manage such cases from their root cause – the cyclitic membrane.
Uveitis clinic of the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India – A tertiary care referral centre in Northern India.
Once other causes of hypotony like acute inflammation have been managed, the presence of a cyclitic membrane is documented by ultrasound biomicroscopy (UBM). The patient is then taken up for surgery, which includes a complete vitrectomy and lensectomy. This is followed by dissection of the epiciliary membrane using the principles of segmentation and delamination. Depending on the status of the ciliary processes, silicon oil may be injected at the end in cases with diffuse atrophy.
The technique of cyclytic membrane removal requires good preoperative planning and imaging using UBM to document the presence of the membrane and document the status of the ciliary processes. The results of the procedure are reproducible and give a reliable control of hypotony and visual rehabilitation in pediatric uveitic eyes.
Management of hypotony in a uveitic eye is a challenge given the extensive damage by inflammation and its sequelae. We demonstrate a simple technique for the successful management of such cases, with good postoperative results.