Ocular parameter changes after phacoemulsification in pseudoexfoliative eyes: case-control study

Purpose: To assess changes of angle morphometric parameters, anterior chamber depth (ACD), intraocular pressure (IOP), and endothelial cell density (ECD) after uneventful phacoemulsification in eyes with pseudoexfoliation syndrome (PEX) compared with those in eyes without PEX and to evaluate the effect of these changes on effective lens position and postoperative refraction. Setting: Papageorgiou Hospital, Thessaloniki, Greece. Design: Prospective case-control study. Methods: Angle opening distance, trabecular-iris space area, and scleral spur angle width were measured using anterior segment optical coherence tomography. ACD was assessed using IOLMaster and ECD using specular microscopy. All parameters were evaluated at baseline and 2 months postoperatively. Results: 42 patients (42 eyes) with PEX and 39 patients (39 eyes) without PEX who underwent uneventful phacoemulsification were enrolled. All angle parameters and ACD increased significantly after phacoemulsification in both groups (P < .001), with no statistically significant difference between them (P > .05). Percentile change in ACD was greater in PEX eyes (P = .017). Regarding the mean refractive prediction error, no statistically significant differences were found between the study groups (P = .68). A statistically significant trend toward hyperopic shift was noted in the PEX group (P = .039). IOP and ECD diminished postoperatively in both groups, with no statistically significant difference between the study groups (P = .09 and P = .22, respectively). Conclusions: PEX, compared with non-PEX eyes, demonstrated a greater anterior chamber deepening and a hyperopic shift after phacoemulsification. These could be related to the zonular laxity in eyes with PEX and imply that PEX eyes may require a modified target refraction to achieve the desired refractive outcome. Copyright (C) 2022 Published by Wolters Kluwer on behalf of ASCRS and ESCRS