Phacoemulsification in Indian eyes with pseudoexfoliation syndrome

To evaluate the intraoperative and postoperative behavior after phacoemulsification in Indian eyes with pseudoexfoliation syndrome.

Iladevi Cataract & Intraocular Lens Research Centre, Ahmedabad, India.

Ninety eyes were prospectively evaluated. Group 1 (cohort) comprised 45 consecutive eyes with pseudoexfoliation and coexisting cataract and Group 2 (control), 45 consecutive normal eyes with senile cataract only. Phacoemulsification was performed by a single surgeon using a step-by-step, chop in situ, and lateral separation technique. An AcrySof intraocular lens was implanted in the bag in all eyes. Intraoperative observations included pupil size after maximal mydriasis, phakodonesis, zonular dehiscence, grade of cataract, and capsule tear/rupture. Postoperatively, intraocular pressure (IOP), best corrected visual acuity, aqueous flare/cell response, and the presence of posterior synechias were evaluated at 1 day and 1 month. A chi-square test was used for statistical analyses.

The mean pupil size was significantly smaller in Group 1 (P =.0000). No eye in either group had phakodonesis. Sixty percent of eyes in Group 1 and 31% in Group 2 had a hard cataract (P =.008). Endocapsular phacoemulsification was performed in 82% of eyes in Group 1 and 84% of eyes in Group 2. Intraoperative complications such as zonular or capsular dehiscence were not seen in any eye. Postoperatively, IOP and aqueous cell response were comparable between groups (P =.11 and P = 0.81, respectively). A significantly higher flare response was observed in Group 1 (P =.000). The visual outcome at 1 month was similar between groups.

The intraoperative performance of Indian eyes with pseudoexfoliation was comparable to that in normal eyes. A good surgical outcome is ensured by using an appropriate surgical technique. Apart from a higher flare response, the postoperative outcomes in eyes with pseudoexfoliation were within normal limits, and the outcome at 1 month was satisfactory.