Microsurgical management of retinal detachment in eyes with pupillary membranes.

A one-stage approach to the combined problem of retinal detachment and pupillary membranes, aided by fiberoptic endoillumination and microscopic viewing through a corneal contact lens, permits simultaneous removal of the pupillary membrane and cortical vitreous along with microsurgical examination of the peripheral retina and closure of all breaks. Four cases of complicated retinal detachment that were treated in this manner are presented. In two, the presence of pupillary membranes was further complicated by vitreoretinal traction. Although it is a departure from traditional techniques of retinal attachment, such a microsurgical approach is surely an additional, and perhaps an advantageous, way in which to perform these complicated surgical procedures.