Pseudoexfoliation Syndrome: A Cohort Study on Intraoperative Complications in Cataract Surgery

Scorolli, L.; Scorolli, Luigi; Campos, Emilio C.; Bassein, Leona; Meduri, R.

doi:10.1159/000027307

Cited by 70 publications

(61 citation statements)

References 13 publications

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“…Lumme et al [7] found significantly higher rates of intraoperative complications including zonular rupture, posterior capsule rupture, and vitreous loss (14.8%, 10.2%, and 7.4%, respectively) during cataract surgery on eyes with PEX, and suggested that zonular and posterior capsule rupture are important risk factors for vitreous loss. Scrolli et al [16] also found higher intraoperative incidences of zonular dialysis, posterior capsule rupture and vitreous loss in PEX patients undergoing phacoemulsification than in patients without pseudoexfoliation. Avramides et al (21) found that 61.9% of the patients with PEX had a pupil diameter of less than 5 mm, and the incidence of intraoperative complications in these patients was as follows: zonulolysis, 13.09%; posterior capsule tear, 10.71%; and vitreous loss, 7.14% [21].…”

Section: Discussionmentioning

confidence: 91%

“…It is considerably more difficult to achieve sufficient pupillary dilation for cataract surgery in eyes with PEX than normal eyes [8,15,16]. Iris haemorrhage, corneal endothelial damage, lens dislocation, vitreous loss, posterior capsule rupture and sphincter rupture occur more frequently in eyes with insufficient intraoperative pupillary dilation during cataract extraction [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

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Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Erkayhan¹,

Doğan²

2017

Eurasian J Med

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Objective: The aim of this study was to evaluate the demographic characteristics and intraoperative complications of cataract surgery in patients with pseudoexfoliation syndrome (PEX). Materials and Methods:Cases of 225 eyes (80 eyes with pseudoexfoliation and 145 eyes without pseudoexfoliation as the control group) that underwent phacoemulsification cataract surgery and IOL implantation at the Silifke State Hospital Ophthalmology Clinic between April 2011 and April 2013 were analysed retrospectively. Patients with a history of previous ocular surgeries, ocular trauma, uveitis, glaucoma or corneal pathology were not included in the study. All cataract procedures were performed by the same surgeon. Patients' age, gender, anterior segment and fundus findings in both eyes, presence of pseudoexfoliative material, pre-and postoperative day 1 intraocular pressure (IOP) and surgery notes were evaluated.Results: There were 51 (34.7%) males and 29 (38.6%) females among the PEX cataract patients, and 98 (65.3%) male and 47 (61.8%) female controls. The incidence of pseudoexfoliation was similar in women (38.2%) and men (34.7%) (p=0.660). The mean age was 74.64±6.8 in the PEX group and 68.95±7.5 in the control group. Mean age was significantly higher in the PEX group compared to controls (p<0.001). Poor pupil dilation occurred intra-operatively in 60 (75%) of the patients with pseudoexfoliation and in 17 (11.7%) of the control patients. Frequency of poor intraoperative pupil dilation was significantly higher in the PEX group (p<0.001). Intraoperative vitreous loss occurred in 7 (8.8%) PEX patients and 5 (3.4%) controls, but this difference was statistically insignificant (p=0.090).Conclusion: Surgeons should be aware of the potential complications of cataract procedures in patients with PEX. Caution should be taken at every stage of the surgery to prevent these complications, and surgeons should be knowledgeable and skilful in complication management should they arise.Keywords: Pseudoexfoliation, cataract surgery, poor pupil dilation, intraoperative complications ÖZ Amaç: Bu çalışmada Psödoeksfoliasyon sendromu (PES)'li katarakt olgularının demografik özelliklerinin ve katarakt ameliyatı sırasında gelişen komplikasyonların değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmada Silifke Devlet Hastanesi göz kliniğinde Nisan 2011 ve Nisan 2013 tarihleri arasın-da fakoemülsifikasyon ile katarakt cerrahisi ve İOL implantasyonu uygulanmış 81 psödoeksfoliasyonlu göz ile kontrol grubu olarak 145 psödoeksfoliasyonsuz göz toplam 226 göz retrospektif olarak incelendi. Önceden geçirilmiş göz cerrahisi, geçirilmiş göz travması, üveit, glokom, kornea patolojisi olan hastalar çalışmaya alınmadı. Katarakt ameliyatları tek bir cerrah tarafından uygulandı. Hastaların yaşı, cinsiyeti, her iki gözünün ön segment ve fundus bulguları, psödoeksfoliatif materyal varlığı, preoperatif-postoperatif 1. gün GİB, ameliyat notları değerlendirildi.Bulgular: Psödoeksfoliasyon sendromlu katarakt olgularının 51' si (%34,7) erkek, 29'i (%38,6) ...

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Erkayhan¹,

Doğan²

2017

Eurasian J Med

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“…Since PXS has been linked to multiple pathological entities of the eye including glaucoma, cataract, perioperative complications during eye surgery [19][20][21][22][23][24] and postoperative complications after cataract surgery 25 , it is of utmost importance to recognize ocular manifestations of PXS. Pseudoexfoliation (PEX) at baseline was identifi ed as an independent risk factor for primary open-angle glaucoma (POAG) and relation between increased intraocular pressure (IOP) and PXS was established in diff erent studies 26,27 , suggesting obstruction of the aqueous humor outfl ow.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma in Population of North-West Croatia Aged 40 and Over

Pavičić-Astaloš

Koluder

Knežević

et al. 2016

acc

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A total of 5349 subjects aged 40 or above presenting for general ophthalmic examination were screened for pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Each patient underwent complete ophthalmologic examination including ocular history, visual acuity testing, slit-lamp examination, applanation tonometry, optic disc evaluation, visual fi eld analysis, and gonioscopy if glaucoma was suspected. Exclusion criteria were pseudophakic and/or aphakic patients of any age, patients with concomitant congenital eye disease, and patients with very dense ocular media opacities. Out of 5349 patients examined, there were 1994 (38.38%) males and 3201 (61.61%) females. Th e prevalence of pseudoexfoliation syndrome was 3.6% and primary open angle glaucoma 9.4%, out of which 23.6% with pseudoexfoliation glaucoma. Th e fi ndings of this study improve our knowledge of pseudoexfoliation syndrome and pseudoexfoliation glaucoma in Croatia, particularly in the northwest region.

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“…Patients were dilated with mydriatic-cycloplegic drops and NSAIDS were used to maintain dilatation. Pupillary diameter after dilatation was measured and graded as poor (2-4mm), moderate (5-6mm), and good (7-9mm or more) [7]. Cataract was graded according to LOCS III grading system.…”

Section: Methodsmentioning

confidence: 99%

Pseudoexfoliation - A Dreaded Nightmare in Cataract Surgery

Kar

Bhuyan

Nanda

2015

Int J of Biomed & Adv Res

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Aim: Pseudoexfoliation (PXE) is a common and clinically important systemic condition in elderly people that affects the outcome of cataract surgery. It can cause various complications during cataract surgery due to pupillary rigidity and zonular weakness and instability. The purpose of this study was to evaluate the frequency and types of complications of Phacoemulsification in patients with cataract and PXE. Materials and Methods: This cross sectional, prospective study was carried out on 60 eyes of 60 patients with cataract and PXE who underwent phacoemulsification in a tertiary care hospital. Their perioperative and postoperative complications were documented and analyzed. Results: Poor pupillary dilatation in spite of use of standard mydriatic drops and NSAID was the most common perioperative finding. This single factor made subsequent steps of surgery more difficult due to poor visualisation. Conclusion: Presence of associated PXE in cataract patients significantly increases the risk of vision threatening complications. Use of flexible iris hooks for small pupils, capsular tension rings for capsular stability and high viscosity viscoelastics are useful adjunct during surgical technique for good visual outcome.

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Pseudoexfoliation Syndrome: A Cohort Study on Intraoperative Complications in Cataract Surgery

Cited by 70 publications

References 13 publications

Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Cataract Surgery and Possible Complications in Patients with Pseudoexfoliation Syndrome

Prevalence of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma in Population of North-West Croatia Aged 40 and Over

Pseudoexfoliation - A Dreaded Nightmare in Cataract Surgery

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