A study of complications during cataract surgery in patients with pseudoexfoliation syndrome

Abstract

Aim: Pseudoexfoliation (PXE) is a common and clinically important systemic condition that affects elderly people, who are also likely to undergo cataract surgery. It can cause serious complications during cataract surgery due to the pupillary rigidity and zonular weakness and instability. The purpose of this study was to study the frequency and types of complications of small incision cataract surgery (SICS) and phacoemulsification surgery in patients with cataract and PXE. Materials and Methods: This cross-sectional descriptive study was carried out on 52 eyes of 52 patients with cataract and PXE who underwent SICS or phacoemulsification surgery in a tertiary care hospital. Their perioperative and post-operative complications were documented and analyzed through statistical package for social sciences version 15.0 (IBM). Results: Poor pupillary dilatation in spite of use of standard mydriatic drops and non-steroidal anti-inflammatory drugs was the most common finding. This single factor made subsequent steps of surgery very difficult due to poor peripheral visualization. Pupillotomy was done in 25% cases. Other problems encountered were accidental iridodialysis, posterior capsule rupture, vitreous loss, retained cortical matter, decentered intraocular lens and zonular dialysis. Conclusion: Presence of associated PXE in cataract patients significantly increases the risk of vision threatening complications. Use of flexible iris hooks for small pupils and for capsular stability, capsular tension rings and high viscosity viscoelastics are useful modifications of surgical technique for good visual outcome.

Keywords

• Iridopathy
• miosis
• phacopathy
• pseudoexfoliation
• zonular weakness