The Perioperative Profile of Community Outreach Camp Patients with Pseudoexfoliation Who Underwent Cataract Surgery in a Tertiary Care Centre

Abstract

Purpose: To study the perioperative profile of pseudoexfoliation (PXF) among the camp patients who underwent cataract surgery. Methods: This retrospective study was conducted among camp patients with PXF, who underwent cataract surgery in a tertiary care centre. Anterior segment examination including distribution of PXF material over anterior segment structures, pupillary dilatation, gonioscopy, applanation tonometry, intraoperative and postoperative complications, and subsequent management were all documented from the records. Results: A total of 1985 patients underwent cataract surgery between November 2016 and October 2019 of which PXF was recorded in 140 (7%) patients. 49 patients had bilateral PXF, while 83 patients had unilateral PXF. 50% (91/181) of eyes had PXF on anterior lens capsule and pupillary border and 67% (113/167) of eyes had both cortical and nuclear cataracts simultaneously. Intraocular pressure (IOP) was significantly elevated in PXF eye of unilateral PXF patients. The prevalence of PXF glaucoma in our study population was 2.8%. 16.7% (22/132) of patients had intraoperative complications of which posterior capsule rent (PCR) occurred more in bilateral PXF patients and zonular dehiscence (ZD) was seen more in unilateral PXF patients. Postoperatively, surge in anterior segment inflammation was noted from 8% on the first day to 11% at the end of the first week. Conclusions: PXF eyes require meticulous preoperative examinations and intraoperative handling to prevent complications like ZD and PCR. Following cataract surgery, these patients require frequent follow-up visits in the initial two weeks of postoperative period to address the surge in anterior chamber reactions.