Cataract surgery outcomes in pseudoexfoliation syndrome: a large multicenter database study.

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Ocular Comorbidities

Background:

• Pseudoexfoliation (PEX) syndrome is a significant risk factor for cataract surgery complications.
• Understanding the specific risks and visual outcomes in PEX eyes is crucial for surgical planning.

Purpose of the Study:

• To compare intraoperative and postoperative complications and visual acuity (VA) outcomes of cataract surgery in pseudoexfoliation (PEX) eyes versus non-PEX eyes.

Main Methods:

• A retrospective analysis of 172,008 eyes undergoing phacoemulsification across UK centers (2003-2015).
• Eyes were categorized by PEX presence and ocular comorbidities.
• Multivariable models assessed adjusted differences in VA and risks of complications.

Main Results:

• PEX eyes showed increased risks of posterior capsular rupture, zonular dialysis, nucleus drop, and conversion to extracapsular extraction.
• Postoperative complications in PEX eyes included higher rates of intraocular pressure ≥ 22 mmHg and IOL dislocation.
• Despite increased complications, PEX eyes achieved similar postoperative VA outcomes and VA gain compared to non-PEX eyes after adjusting for copathology.

Conclusions:

• Cataract surgery in PEX eyes is associated with a higher incidence of intraoperative complications.
• Visual outcomes following cataract surgery in PEX eyes are favorable and comparable to non-PEX eyes.
• Findings support informed clinical decision-making and patient counseling for cataract surgery in individuals with PEX.