Analysis of Intraoperative and Postoperative Complications in Pseudoexfoliation Eyes Undergoing Cataract Surgery

Hemalatha, B C

doi:10.7860/jcdr/2016/17548.7545

Cited by 15 publications

(19 citation statements)

References 22 publications

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“…Intraoperative difficulties in cataract surgery in patients with PXF syndrome have been reported in various studies. [946474849] However, Shastri and Vasavada have reported that intraoperative performance of cataract surgery in PXF eyes is comparable to that in non-PXF eyes. [50] In our study, intraoperative difficulties occurred in 62 eyes (27.4%) while performing cataract surgery by phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Joshi

Singanwad

2019

Indian J Ophthalmol

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Purpose: To study the frequency and intraoperative difficulties associated with pseudoexfoliation (PXF) syndrome at a tertiary eye care center in a rural central India. Methods: This study included patients scheduled for cataract surgery who were diagnosed with PXF syndrome. All patients underwent a complete ophthalmologic evaluation, including slit-lamp examination, tonometry, gonioscopy, and ophthalmoscopy before the surgery. Cataract surgeries were performed by a single surgeon who reported the intraoperative difficulties. Results: In total, 1022 phakic eyes of 1823 patients were evaluated, 226 of whom (22.1%) were diagnosed with PXF syndrome. Most eyes ( n = 81, 35.8%) with PXF syndrome were ≥81 years old. Eighty-six eyes (38.1%) had bilateral involvement, whereas 70 (30.9%) had right or left eye involvement. Further, PXF material was distributed on the iris, pupil, and lens in 70 eyes (30.9%) and on the pupillary margin in 36 eyes (15.9%). The mean pupillary dilation was 5.1 (±1.4) mm in patients with PXF syndrome compared with 7.2 (±1.6) mm in those without it ( P = 0.03). Grade VI cataract was observed in 93 eyes (41.2%) and hypermature cataract was the most commonly observed cataract stage. Twenty-one eyes (9.3%) had increased intraocular pressure. Intraoperative difficulties were encountered in 62 eyes (27.4%) with poor pupillary dilation being the most common problem (32 eyes, 14.2%), followed by zonular dehiscence (18 eyes, 8%). Conclusion: This hospital-based study showed that PXF syndrome is common in Indian rural population and that the intraoperative complication rate in these patients is high.

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Section: Discussionmentioning

confidence: 99%

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Joshi

Singanwad

2019

Indian J Ophthalmol

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“…In a study performed by Hemalatha, B.C. et al [11], out of 50 cases, 32 were male patients, and 18 were female patients. High ultraviolet exposure may be one of the reasons for male predominance in the Indian population.…”

Section: Discussionmentioning

confidence: 97%

A study of clinical spectrum of pseudo exfoliation syndrome

Triveni

Divya

Lakshmi

et al. 2019

Trop J Ophthalmol Otolaryngol

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Background: Pseudoexfoliation syndrome (PXS) is the most common identifiable cause of secondary glaucoma, the prevalence of which varies considerably among different (PXF) ethnicities. Pseudoexfoliation is a genetically inherited condition. The prevalence of pseudoexfoliation increases with age. It is a common condition in the elderly population. This study aimed to assess the prevalence of and complications in patients with pseudo-exfoliation. Methods: This is an observational study performed in a sample of 103 patients (112 eyes) with pseudo-exfoliation for one year from October 2017-September-2018. Patients visiting the Ophthalmology department, NRI General Hospital, Chinakakani were enrolled in this study. Detailed evaluation including ophthalmic and general history, slit lamp biomicroscope, intraocular pressure measurement, gonioscopy and detailed eye examination was performed in all patients. Results: A total of 103 patients were analyzed; the major age group was 71-80 (40.78%). Among the Male patients were found to be more (66.02%). Majority of the patients were affected unilaterally (91.26%) and remaining bilaterally (8.24%). On slit-lamp examination degranulation of pupillary ruff and pseudoexfoliation material on the anterior capsule of the lens were present in 59.82% and 52.70% whereas corneal endothelium pigments, iris transillumination defects and pigments on the anterior lens capsule were absent in 82.1%, 91.1% and 68.80% respectively. All the cases were identified with PXF material on pupillary margin of the iris. Majority of the patients (72.32%) had normal intraocular pressure. Glaucoma and ocular hypertension were seen in 20.53% and 7.14% of eyes. On gonioscopy, pseudoexfoliation material in the angle, pigments and sampaolesi's line were identified in 27.7%, 63.4% and 43.80% respectively. Only 8.69% of eyes had 6/24 or better vision, while 8.69% had perception of light (PL) to No perception of light in PXF Glaucoma patients. Conclusion: The study concluded the need for early diagnosis and various complications involved in pseudoexfoliation.

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“…It appears as a protective factor with a 0.52 success rate. Studies all over the world recognize PEX as a risk factor to be in mind during surgery to avoid complications [ 23 , 24 ]. The geographic distribution of PEX is favoring surgeons to familiarize and master the techniques needed to prevent complications in the existence of such a factor.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the scoring system [ 7 ] used, previous vitrectomy [ 14 , 15 ], small pupil (<3 mm) [ 16 , 17 ], shallow anterior chamber (depth <2.5 mm) [ 18 ], age >88 years [ 19 - 21 ], high ametropia (>6 D of myopia or hyperopia) [ 22 ], pseudoexfoliation (PEX) [ 23 , 24 ], white/intumescent cataract [ 25 , 26 ], posterior polar cataract [ 15 ], phacodonesis/iridodonesis [ 15 ], miscellaneous risks assessed by the surgeon at the pre-operative check (poor cooperation or position of eye/patient [ 15 , 27 ], medication such as a1 blockers [ 28 , 29 ], and corneal scarring [ 15 ] were described and documented preop. Each one of them was given one score point except for white/intumescent cataract, PEX, and phacodonesis/iridodonesis, which were given three points.…”

Section: Methodsmentioning

confidence: 99%

Reoperations After Cataract Surgery: Is the Incidence Predictable Through a Risk Factor Stratification System?

Oustoglou¹,

Tzamalis²,

Mamais³

et al. 2020

Cureus

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Introduction The objective of the study was to quantify the number of procedures needed to achieve the best possible surgical outcome, depending on the number and type of risk factors identified. Methods Two independent observers reviewed the medical records of 1,502 patients who underwent phacoemulsification surgery, during a two-year period (January 1, 2014 to December 31, 2015). Preoperative risk factors were documented according to the stratification system used. Based on the total risk score, each case was allocated to one of four risk groups with 0, 1-2, 3-5, and >6 total risk factors, respectively. All qualitative and quantitative characteristics were gathered and included in a multivariate analysis. Results A total of 1,792 eyes were included. Αge over 88 years, low cooperation ability with the patient, and surgeries performed by residents tended to have more often complications, while white/intumescent cataract, iridodonesis/phacodonesis, α1 blockers intake, and male gender are risk factors positively associated with more than one surgery. Conclusions Risk factors tend to be prognostic for possible intraoperative complications. The number of procedures needed for the best possible surgical outcome seems to depend on these preoperative risk factors. A stratification method increases the level of awareness of the surgeon, and therefore may decrease the number of complications and even procedures while enhancing the "safe" practice and skills of residents.

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Analysis of Intraoperative and Postoperative Complications in Pseudoexfoliation Eyes Undergoing Cataract Surgery

Cited by 15 publications

References 22 publications

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

Frequency and surgical difficulties associated with pseudoexfoliation syndrome among Indian rural population scheduled for cataract surgery: Hospital-based data

A study of clinical spectrum of pseudo exfoliation syndrome

Reoperations After Cataract Surgery: Is the Incidence Predictable Through a Risk Factor Stratification System?

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