Pseudoexfoliation: High risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification

Area of Science:

• Ophthalmology
• Surgical Outcomes

Background:

• Pseudoexfoliation (PXF) syndrome can cause zonular weakness, increasing risks during cataract surgery.
• Concurrent vitrectomy may be necessary in complex PXF cases.

Purpose of the Study:

• To determine the frequency of concurrent vitrectomy during cataract surgery in eyes with pseudoexfoliation (PXF).
• To compare the outcomes of cataract surgery with and without concurrent vitrectomy in PXF eyes.

Main Methods:

• Retrospective analysis of 1059 eyes with PXF undergoing cataract surgery.
• Eyes were categorized as high-risk (phacodonesis, iridodonesis, etc.) or non-high-risk.
• Outcomes, including corrected distance visual acuity (CDVA) and intraocular pressure (IOP), were compared between groups.

Main Results:

• Concurrent vitrectomy was performed in 38 eyes (3.6%), more frequently in high-risk eyes (15.6%) than non-high-risk eyes (2.0%).
• Highest vitrectomy rates were observed in cases with fellow eye zonular issues (72.7%) and phacodonesis/iridodonesis (42.9%).
• No significant difference in mean CDVA improvement or IOP change was found between vitrectomy and no-vitrectomy groups.

Conclusions:

• Concurrent vitrectomy in PXF eyes, despite increased complexity, did not negatively impact visual acuity or IOP outcomes.
• Both groups achieved improved corrected distance visual acuity and intraocular pressure post-surgery.