Intraoperative and Immediate Postoperative Outcomes of Cataract Surgery using Phacoemulsification in Eyes with and without Pseudoexfoliation Syndrome

Dwivedi, Neelam; Dubey, Arun Kumar; Shankar, Pathiyil Ravi

doi:10.7860/jcdr/2014/10004.5277

Cited by 14 publications

(13 citation statements)

References 28 publications

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“…While the presence of zonular dialysis has commonly been reported in pseudoexfoliation syndrome (PXF) or trauma, studies reporting the incidence, and specifically visual outcomes, of zonular dialysis detected at cataract surgery are limited. 1 The UK CND audit of 55 297 patients identified a zonular dialysis rate of 0.46%. 2 Zonular dialysis has been associated with a variety of adverse outcomes including early or late in-the-bag IOL dislocation, and progressive asymmetrical capsular contraction resulting in IOL decentration.…”

Section: Introductionmentioning

confidence: 99%

Visual outcomes in patients with zonular dialysis following cataract surgery

Trikha

Agrawal

Saffari

et al. 2016

Eye

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Purpose To evaluate the visual outcomes of patients with zonular dialysis following cataract surgery. Patients and methods Medical records of all patients with documented zonular dialysis, either pre-or peri-operatively, undergoing cataract surgery between 2004-2010 at Queen Alexandra Hospital, Portsmouth, were retrospectively reviewed. Baseline demographics and biometry were analysed, and ocular co-morbidities documented. Intraoperative complications and the use of a capsular tension ring (CTR) were identified. Early and late best-corrected visual acuity (BCVA) post surgery were determined using LogMar values. Univariate and multivariate linear regression analysis was performed to determine associations with BCVA post surgery, and further subgroup analysis performed in groups determined by CTR use. Results The records of 22 312 consecutive eyes undergoing cataract surgery were reviewed. The incidence of zonular dialysis was 0.50% (111 eyes). A CTR was inserted in 46 eyes. Using a multivariate linear regression model, better initial pre-operative BCVA (P = 0.019), the use of a CTR (P = 0.014), and the absence of vitreous loss during surgery (P = 0.008, β 0.45) were associated with improved early postoperative BCVA (mean follow-up 6.6 weeks). Better medium-term postoperative BCVA was significantly associated with preoperative BCVA (P = 0.002) and the use of a CTR during surgery (P = 0.004, β − 0.41). Conclusions The overall incidence of zonular dialysis is low. CTR use intraoperatively suggests improved early and medium-term BCVA and should be considered in all cases of zonular dialysis.

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Section: Introductionmentioning

confidence: 99%

Visual outcomes in patients with zonular dialysis following cataract surgery

Trikha

Agrawal

Saffari

et al. 2016

Eye

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“…In addition, the complication rate in the PEX group was higher in this study than in the control group, but this was not statistically significant. Similarly, the complication rates in the PEX group were found to be high in many studies, but this was not statistically significant [ 41 ]. These complications, which are not statistically significant, are predicted to be due to differences in cataract morphology and the ages of the patients.…”

Section: Discussionmentioning

confidence: 99%

Decorin, Tenascin C, Total Antioxidant, and Total Oxidant Level Changes in Patients with Pseudoexfoliation Syndrome

Oruc

Keser

Yusufoğlu

et al. 2018

Journal of Ophthalmology

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Purpose Pseudoexfoliation syndrome (PEX) is an eye disease that develops under the influence of regional population differences, genetic factors, age, and environmental factors and is characterized by visualization of a gray-white fibrogranular substance in the lens anterior capsule and/or pupil margin during anterior segment examination. The underlying biochemical mechanisms of the disease have not yet been fully elucidated. Therefore, this study was designed to show the changes in aqueous humor and blood serum levels of matrix metalloproteinases (decorin and tenascin C), total antioxidants (TAS), and total oxidants (TOS) in both cataract patients who have unilateral PEX material and cataract patients who do not have unilateral PEX material. Methods Biological samples were simultaneously collected from 22 cataract patients who had unilateral pseudoexfoliation (PEX patients) and 22 cataract patients who did not have unilateral pseudoexfoliation (control patients). From the collected biological samples, decorin (DEC) and tenascin C (TN-C) were measured with the enzyme-linked immunosorbent assay (ELISA) method, and TAS and TOS were measured with an autoanalyzer. Results When decorin, tenascin C, and TOS values of PEX patients were compared with those of control patients, there was a statistically significant increase in all three parameters. Conversely, TAS values showed a statistically significant decrease in PEX patients compared to controls. DEC, TN-C, TAS values, and TOS values were significantly higher in aqueous fluid than in blood in both the PEX patient and control groups. Conclusions We suggest that parameters such as DEC, TN-C, TAS, and TOS play a role in the etiopathology of pseudoexfoliation syndrome. Thus, bringing these increased levels of extracellular proteins and TOS and decreased levels of TAS back to within physiological limits can mediate the reorganization of the blood-aqueous fluid barrier and slow the progression of pseudoexfoliation syndrome.

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“…[5] Other studies do not show an association between the presence of pseudoexfoliation and intraoperative complications. [6] Thanigasalam et al . and Sufi found no correlation was found between PCR and the presence of PXM during phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

The Melaka Hospital cataract complications study analysis of 12,992 eyes

Thevi¹,

Maizura²,

Abas³

2017

Indian J Ophthalmol

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Introduction:As in all surgeries, complications during cataract surgery are unavoidable and cause distress to the surgeon and the patient. This study was conducted to know the factors contributing to complications in our settings, to be able to counsel patients about complications and outcomes and to reduce litigations.Materials and Methods:The secondary data analysis was conducted using the National Eye Database from 2007 to 2014. Demographic features, ocular comorbidities, technique of surgery, grade of surgeons, types of intraoperative complications, and reasons for not obtaining good visual acuity following intraoperative complications were studied. Statistics was done using Statistical Package for Social Sciences version 20.Results:Out of 12,992 eyes, 6.1% had intraoperative complications. The highest rate of complications was when more trainees (medical officers [MOs] and gazetting specialists) operated. Posterior capsule rupture (PCR) was the most common complication followed by vitreous loss and zonular dehiscence. Those aged below 40 years had more complications (P < 0.05), and females had more complications. Ethnicity did not affect complications. Pseudoexfoliation was the only comorbidity causing complications (P < 0.05). Phacolytic lenses had 8.118 times the odds of getting intraoperative complications. MOs and gazetting specialists got more complications. Good outcomes were obtained in cases without complications and those operated by specialists. High astigmatism was the main reason for poorer outcomes.Conclusion:Intraoperative complications were caused mostly by less experienced doctors and had poorer outcomes. Age below 40 years, females, the presence of pseudoexfoliation and phacolytic lenses had more complications. PCR was the most common complication.

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Intraoperative and Immediate Postoperative Outcomes of Cataract Surgery using Phacoemulsification in Eyes with and without Pseudoexfoliation Syndrome

Cited by 14 publications

References 28 publications

Visual outcomes in patients with zonular dialysis following cataract surgery

Visual outcomes in patients with zonular dialysis following cataract surgery

Decorin, Tenascin C, Total Antioxidant, and Total Oxidant Level Changes in Patients with Pseudoexfoliation Syndrome

The Melaka Hospital cataract complications study analysis of 12,992 eyes

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