Outcome of Phacoemulsification in patients with and without Pseudoexfoliation syndrome in Kashmir

Sufi, Aalia Rasool; Singh, Tejit; Mufti, Asmat A; Rather, Mudassar H

doi:10.1186/1471-2415-12-13

Cited by 24 publications

(28 citation statements)

References 20 publications

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“…Patients with pseudoexfoliation syndrome were significantly older, had smaller pupil diameter and higher IOP than controls. These findings are similar to recently published study results [13]. Out of 300 patients with cataract and pseudoexfoliation syndrome, 30 (10%) had capsular glaucoma, which is statistically significantly more frequent than in controls.…”

Section: Discussionsupporting

confidence: 92%

Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

Veselinović¹,

Cvetanovic²,

Milošević³

et al. 2017

Srp Arh Celok Lek

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Introduction/Objective Pseudoexfoliation syndrome (PEX) is an age-related systemic disorder characterized by deposition of fibrillary white flaky material mainly on the lens capsule, corneal endothelium, zonules, ciliary body, iris, and pupillary margin. Zonular weakness progressively increases along with the hardness of the lens, patient's age, and the presence of glaucoma. The objective of the study is to compare the intraoperative and postoperative complications of phacoemulsification in cataract eyes with PEX with cataract eyes without PEX. Methods The study enrolled 300 eyes with consequently operated senile cataract and PEX and consequently operated eyes with cataract without PEX who underwent phacoemulsification performed by one experienced surgeon (single-surgeon series). A complete ophthalmological examination of all patients was performed preoperatively, as well as on the first, seventh, and 180th day postoperatively. Results Significant statistical differences between the observed groups were the following: patients with PXF were older (74.2 ± 8; range 56-82 years vs. 68.1 ± 9.6; range 56-79 years), had smaller pupil diameter, and higher intraocular pressure (IOP) preoperatively (16.1 ± 4.1 vs. 13.8 ± 3.7 mmHg). There were no differences between the groups regarding intraoperative complications. Early postoperative complications were a significant rise of IOP (33 vs. six patients; p < 0.001), more frequent postoperative corneal edema (36 vs. 21 patients; p < 0.036), and anterior chamber inflammation (17 vs. seven patients; p < 0.037) in the PEX group, comparing to the control group. The significant late postoperative complication was elevated IOP (24 vs. five patients; p < 0.0002) in patients with PEX. Conclusion In the hands of an experienced and careful surgeon, phacoemulsification is a safe and beneficial surgery to treat cataract with associated pseudoexfoliation. The greatest problem a surgeon faces is a narrow pupil and zonule instability, and difficulty in recognizing eyes that are particularly at risks, such as those having glaucoma and phacodonesis.

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Section: Discussionsupporting

confidence: 92%

Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

Veselinović¹,

Cvetanovic²,

Milošević³

et al. 2017

Srp Arh Celok Lek

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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%

“…[51] The common intraoperative complication observed in our study was zonular dehiscence ( n = 18, 8%), consistent with the findings in several studies. [4647484951] This complication is expected in patients with PXF syndrome, particularly in cases of high-grade cataract. Another complication is non-dilating pupil or decreased pupil dilation during the surgery.…”

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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“…and Sufi found no correlation was found between PCR and the presence of PXM during phacoemulsification. [78] Pterygium involving the cornea, corneal opacity, glaucoma, and chronic uveitis were not associated with intraoperative complications in our study. Pterygium and corneal opacities extending to the visual axis may hamper the view for capsulorhexis and phacoemulsification, but this did not cause an increase in complications.…”

Section: Discussionmentioning

confidence: 46%

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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Outcome of Phacoemulsification in patients with and without Pseudoexfoliation syndrome in Kashmir

Cited by 24 publications

References 20 publications

Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

Intraoperative and postoperative complications of phacoemulsification in cataract eyes with pseudoexfoliation syndrome

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

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

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