Related Experiment Video
Updated: Sep 17, 2025
04:27
Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
Published on: May 9, 2025
162
Aravind Pseudoexfoliation Study (APEX): 10-Year Postoperative Results
Aravind Haripriya1, Shivkumar Chandrashekharan2, Emily M Schehlein3
1From the Aravind Eye Hospital, Chennai, India (A.H., M.S.U.).
American Journal of Ophthalmology
|July 2, 2025
Summary
Long-term cataract surgery outcomes show no significant difference in intraocular lens decentration or neodymium-doped yttrium aluminum garnet capsulotomy rates between eyes with and without pseudoexfoliation. Best-corrected visual acuity was slightly better in the control group after 10 years.
Area of Science:
- Ophthalmology
- Cataract Surgery Outcomes
- Intraocular Lens (IOL) Technology
Background:
- Pseudoexfoliation (PEX) syndrome can complicate cataract surgery, potentially affecting intraocular lens (IOL) stability and visual outcomes.
- Long-term data comparing IOL decentration and posterior capsule opacification (PCO) rates in PEX versus non-PEX eyes are limited.
- Understanding these long-term effects is crucial for optimizing surgical techniques and IOL selection in PEX patients.
Purpose of the Study:
- To compare 10-year rates of IOL decentration and neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomy for PCO after cataract surgery.
- To evaluate the impact of PEX on best-corrected visual acuity (BCVA) over a decade.
- To assess the role of capsular tension rings (CTRs) and different IOL types in eyes with PEX.
Main Methods:
- A clinical cohort study utilizing randomized control trial data.
- 930 eyes with PEX and 476 control eyes without PEX underwent cataract surgery with either a single-piece or 3-piece acrylic IOL.
- The PEX group was further randomized to receive or not receive CTRs; follow-up extended to 10 years.
Main Results:
- IOL decentration (2.4% vs 1.7%) and Nd:YAG capsulotomy rates (5.7% vs 5.67%) were statistically similar between PEX and control groups.
- Capsular phimosis and non-overlapping capsulorhexis were identified as risk factors for IOL decentration and Nd:YAG capsulotomy.
- At 10 years, BCVA was significantly better in the control group (0.08 vs 0.12 logMAR; P = .035).
Conclusions:
- In eyes without preoperative zonular weakness, 1-piece and 3-piece IOLs, with or without CTRs, showed no significant long-term differences in decentration or Nd:YAG capsulotomy rates in the presence of uncomplicated PEX.
- The study provides the first long-term, large-scale prospective comparison of these outcomes.
- While BCVA was slightly better in controls, the overall surgical outcomes were comparable over 10 years.
