Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

The aim of this study was to evaluate the demographic characteristics and intraoperative complications of cataract surgery in patients with pseudoexfoliation syndrome (PEX).

Cases of 225 eyes (80 eyes with pseudoexfoliation and 145 eyes without pseudoexfoliation as the control group) that underwent phacoemulsification cataract surgery and IOL implantation at the Silifke State Hospital Ophthalmology Clinic between April 2011 and April 2013 were analysed retrospectively. Patients with a history of previous ocular surgeries, ocular trauma, uveitis, glaucoma or corneal pathology were not included in the study. All cataract procedures were performed by the same surgeon. Patients' age, gender, anterior segment and fundus findings in both eyes, presence of pseudoexfoliative material, pre- and postoperative day 1 intraocular pressure (IOP) and surgery notes were evaluated.

There were 51 (34.7%) males and 29 (38.6%) females among the PEX cataract patients, and 98 (65.3%) male and 47 (61.8%) female controls. The incidence of pseudoexfoliation was similar in women (38.2%) and men (34.7%) (p=0.660). The mean age was 74.64±6.8 in the PEX group and 68.95±7.5 in the control group. Mean age was significantly higher in the PEX group compared to controls (p<0.001). Poor pupil dilation occurred intra-operatively in 60 (75%) of the patients with pseudoexfoliation and in 17 (11.7%) of the control patients. Frequency of poor intraoperative pupil dilation was significantly higher in the PEX group (p<0.001). Intraoperative vitreous loss occurred in 7 (8.8%) PEX patients and 5 (3.4%) controls, but this difference was statistically insignificant (p=0.090).

Surgeons should be aware of the potential complications of cataract procedures in patients with PEX. Caution should be taken at every stage of the surgery to prevent these complications, and surgeons should be knowledgeable and skilful in complication management should they arise.