Surgical technique for removing congenital fibrovascular pupillary membrane, with clinicopathological correlation

Congenital fibrovascular pupillary membrane, rare in newborns, poses challenges for the ophthalmic surgeon. Predicting its clinical course is difficult, as is removing the membrane surgically without inducing a cataract. We describe a 22-day-old girl who presented with a pupillary membrane causing progressive decrease in the size of the dilated pupil, necessitating removal at 4 months of age. Histopathology demonstrated tissue of embryonic muscle origin, suggesting that the membrane was more likely a remnant of fetal iris than of fetal vasculature. The smooth muscle or fibroblastic elements in the tissue explains progressive contracture of the membrane.