Long-term results of phacoemulsification in pseudoexfoliation syndrome

Introduction. - The prevalence of pseudoexfoliation syndrome is estimated at 8% of all cataracts operated within our institution. The goal of our study was to describe the frequency of intraoperative and postoperative complications and long-term anatomical and functional results of phacoemulsification in pseudoexfoliation syndrome. Patients and methods. - A retrospective observational study of a series including 10] patients (107 eyes) with cataract associated with pseudoexfoliation syndrome admitted between January 2010 and September 2014. All patients underwent phacoemulsification. Results. - The average age of our patients was 72.5 +/- 6 years. The average initial corrected visual acuity was 0.52 +/- 0.14 LogMAR. The cataract was grade C3N3 in 58% of cases. The pseudoexfoliation syndrome was bilateral in 69% of cases. Pupillary dilatation was <= 6 mm in 54% of cases. Among intraoperative complications, zonular dialysis was found in 1.8% of cases. Posterior capsular rupture and vitreous loss was noted at 5.4% of patients. The incidence of secondary cataract was 31.7% at 12 months. The mean postoperative best corrected visual acuity was 0.13 +/- 0.15 LogMAR. Discussion. - The small pupil associated with high grade of the cataracts in our series explains the slightly higher frequency of intraoperative zonular dialysis. Cataract surgery by phacoemulsification allows for a statistically significant improvement in visual acuity (P < 0.001). The incidence of secondary cataract, the main postoperative complication, is higher in our series compared to data in the literature. Conclusion. - Pseudoexfoliation syndrome is common in our country. Functional results of phacoemulsification are very satisfactory, and secondary cataract is the main complication. A meticulous search for pseudoexfoliation is mandatory during the initial examination in order to reduce intraoperative complications. Careful removal of the cortex and systematic polishing of the lens capsule should limit the incidence of secondary cataracts. (C) 2016 Elsevier Masson SAS. All rights reserved.