The Outcomes of Cataract Surgery in Small and Normal Pupillary Eyes with Pseudoexfoliation

Abstract

Introduction:To evaluate the outcomes of cataract surgery and anterior chamber parameters in pseudoexfoliation cases in our clinic.Methods:The patients, who were admitted to our clinic between 01.03.2016 and 01.04.2019 and who were found to have cataract and pseudoexfoliation in the examination, were divided into two groups according to dilated pupillary diameter above and below 5 mm before cataract surgery. Preoperative and postoperative visual acuities, intraocular pressure levels, anterior chamber depths and perioperative posterior capsule opening, development of floppy iris syndrome and corneoscleral suture rates were evaluated.Results:Sixty eyes of 60 patients, including 31 male (51.7%) and 29 female (48.3%) patients, with a mean age of 70.2±7.1 (range: 57-82) years, were included. Patients with pupillary diameter above 5 mm were included in group 1, and those below 5 mm were included in group 2. Preoperative and postoperative visual acuity according to Snellen chart, intraocular pressure and anterior chamber depths of patients in group 1 were 0.2±0.1 (range: 0.1-0.4) vs 0.6±0.2 (range: 0.2-1.0), 16.9±1.7 (range: 14-20) mmHg vs 15.2±1.2 (range: 12-17) mmHg, and 3.04±0.31 (range: 2.29-3.73) mm vs 3.81±0.38 (range: 2.48-4.36) mm, respectively. Preoperative and postoperative visual acuity according to Snellen chart, intraocular pressure and anterior chamber depths of patients in group 2 were 0.1±0.1 (range: 0.1-0.4) vs 0.7±0.2 (range: 0.3- 1.0), 17.1±1.5 (range: 14-20) mmHg vs 16±1.5 (range: 12-19) mmHg, and 2.98±0.44 (range: 1.98-3.88) mm vs 3.99±0.54 (range: 3.29-5.46) mm, respectively. In group 1, three eyes (10%) had floppy iris syndrome, four eyes (13.3%) had posterior capsule rupture, and corneoscleral suture was performed in three eyes (10%). In group 2, one eye (3.3%) had floppy iris syndrome, one eye (3.3%) had posterior capsule rupture and corneoscleral suture was performed in one eye (3.3%). There was no statistically significant difference between two groups in terms of age, gender, development of floppy iris syndrome, posterior capsule rupture, corneoscleral suturing, preoperative and postoperative visual acuity, intraocular pressure and anterior chamber depths (p=0.304, p=0.508 for male, p=0.509 for female, p=0.500, p=0.447, p=0.500, p=0.304, p=0.904, p=0.644, p=0.025, p=0.437, p=0.150, respectively).Conclusion:Pseudoexfoliation is more likely to occur with small pupils. Both conditions involve an increased risk of complications during cataract surgery.

Keywords

• pseudoexfoliation
• cataract
• small pupil