Incising the thick retrolental fibrovascular tissue with a hooked sclerotome in persistent hyperplastic primary vitreous

A technique for incising thick retrolental fibrovascular tissue and extensi ve cyclitic membrane is reported in a case of anterior persistent hyperplas tic primary vitreous. A membranectomy was performed in a 1-month-old post-l ensectomy baby via a limbal approach. A sclerotome tip was hooked to cut th rough an extremely thick fibrovascular tissue by rotating the sclerotome by its grip. Sutherland microscissors (Grieshaber, Switzerland) and a vitrect omy cutter were used for further membranectomy. The baby was followed-up un til age 18 months. A total of 3 membranectomy sessions were required becaus e of rapid cyclitic membrane formation, severe centripetal retraction of th e membrane on the ciliary processes, and posterior synechia. Thorough membr anectomy and cutting the iris edge maintained a clear pupillary area during the 13-month post-operative period. Extremely thick retrolental fibrovascu lar tissue is a challenging condition that can be dealt with by delicate in strumentation.