Cataract surgery in patients with ocular pseudoexpholiation

Area of Science:

• Ophthalmology
• Surgical Science

Background:

• Pseudoexfoliation syndrome (PES) is a common condition associated with an increased risk of intraocular complications during cataract surgery.
• Patients with PES often present with specific challenges, including small pupils, shallow anterior chambers, and compromised zonular support.

Purpose of the Study:

• To evaluate the surgical outcomes and complication rates of cataract surgery in patients with pseudoexfoliation syndrome.
• To present optimal surgical approaches and management strategies for cataract surgery in the context of PES.

Main Methods:

• A retrospective 5-year study involving 268 eyes from 174 patients aged 50 years and over with PES.
• Ophthalmological examinations included visual acuity, intraocular pressure measurement, slit lamp examination, and indirect ophthalmoscopy.
• Surgical techniques, such as extra capsular cataract extraction and phaco-emulsification, were tailored to individual patient needs.

Main Results:

• Preoperative findings included phacodonesis (17.91%), iridodonesis (2.98%), pigment dispersion (6.72%), and lens subluxation (4.85%).
• Intraoperative complications observed were posterior capsular rupture (17.91%), vitreous loss (13.80%), and zonular dialysis (5.97%).
• Postoperative complications included anterior chamber reaction (45.90%), endothelial decompensation (21.64%), and secondary cataract (21.46%).

Conclusions:

• Cataract surgery in patients with PES frequently presents challenges such as small pupils, shallow anterior chambers, and weak zonular support.
• The study highlights the importance of tailored surgical approaches and meticulous technique to manage potential complications effectively.
• Effective management strategies are essential for optimizing visual outcomes in patients undergoing cataract surgery with pseudoexfoliation syndrome.