Posters

Pseudoexfoliation syndrome and cataract: results and complication frequency in immature and mature cataract surgery

Poster Details

First Author: M. Bilen Babić CROATIA

Co Author(s):    M. Merlak                    

Abstract Details

Purpose:

Pseudoexfoliation syndrome (PEX) is complex, multifactorial age-related systemic disease manifesting itself primarily in the eyes with deposition of a microscopic fibrogranular amyloid-like protein material in the anterior segment of the eye. Cataract surgery in PEX is known to be associated with complicating factors such as poor mydriasis, zonular weakness, corneal endothelial dysfunction, vitreous loss, capsular phimosis and rupture and luxation of the lens. The aim of our study was to evaluate intraoperative and postoperative mature and immature cataract surgery results and complications in eyes with PEX, compared with mature and immature cataract surgery results in the eyes without PEX.

Setting:

In our retrospective single-center study, we analyzed the clinical data of 23 eyes with mature cataract and PEX syndrome and 25 eyes with immature cataract and PEX in patients who underwent cataract surgery. The results obtained were compared with 48 eyes without PEX syndrom that underwent cataract surgery (control group).

Methods:

48 eyes of 46 patiens with PEX syndrome were included in the study and results were compared depending on the degree of cataract maturity and compared to the control group without PEX. All eyes underwent phacoemulsification cataract surgery. We analyzed mean preoperative and postoperative best corrected visual acuity (BCVA), values of intraocular pressure (IOP) before and 1 month after cataract surgery beetween patient groups. The rate of surgical intraoperative (zonular rupture, posterior capsule tear, vitreous loss, dropped lens material, hyphaema) and postoperative complications (introcular lens dislocation) was analyzed. All results were compared with the control group without PEX syndrome.

Results:

The mean preoperative BCVA in PEX group was 0,024-0,2 and postoperative BCVA was 0,19-0,4 according to Snellen chart. In the control group preoperative BCVA was 0,05-0,46 and postoperative BCVA 0,3-0,87. Preoperative IOP was in 18,21-18,91 mmHg in PEX group and 17,80-18,19 mmHg in control group. Postoperative IOP at 1 month was 17,84-18,2 mmHg in the PEX and 15,23-17,38 mmHg in the control group. 15 cases of PEX eyes and mature cataract (31%) had one or more intraoperative complications, compared to 3 eyes (6%) with immature cataract and PEX. In control group 7 eyes (15%) with mature cataract had intraoperative complications.

Conclusions:

Cataract surgery with PEX syndrome is associated with a greater number of possible operative complications, especially depending on the degree of maturity of the cataract. In immature cataract there is no difference in the number of complications in patients with PEX compared to those without PEX. In mature cataract, there are significant operative complications in patients with PEX syndrome. Phacoemulsification represents a safe method in eyes with PEX with careful surgical technique: maximal mydriasis or use of iris retractor hooks for poor pupillary dilatation, implantation of endocapsular rings in zonular instability/phacodonesis and good intraoperative and postoperative IOP control.

Financial Disclosure:

NONE