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Jennifer L Barger, Edmund Tsui, Kevin C Chen, Ilyse Haberman, Jordan Lee, Lisa Park; Epidemiology of pseudoexfoliation syndrome in a Guatemalan population – 2-year follow-up. Invest. Ophthalmol. Vis. Sci. 2017;58(8):781.
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Pseudoexfoliation (PXF) syndrome is known to be associated with glaucoma, zonular weakness, reduced pupil dilation, and cataract progression. This retrospective study presents two-year follow-up of a Guatemalan population undergoing cataract surgery.
279 eyes of 259 patients who underwent cataract surgery at Hospital de la Familia in Guatemala in 2014 and 2015 were reviewed retrospectively. Eyes necessitating combined glaucoma filtration procedures and traumatic subluxed lenses were excluded. Records were reviewed for presence of PXF material, pre-operative visual acuity, cataract density, intraocular pressure (IOP), cataract extraction technique, intraocular lens (IOL) placement site, and surgical complications. Fisher exact test and chi-square test were used for categorical variables, and two-tailed T test was used for continuous variables. Statistical significance was defined as p ≤ 0.05.
233 eyes (83%) had vision worse than 20/200 preoperatively. Phacoemulsification and extracapsular extraction were performed in 60 eyes (22%) and 219 eyes (78%), respectively. The most common complications were elevated IOP (>30 mmHg) on post-operative day 1 (19%), poor intraoperative pupil dilation (13%), zonular abnormalities (10%), vitreous loss (10%), posterior capsular tear (8%), incomplete cortex removal (8%), and iris trauma (5%). Other complications included post-operative hyphema (3%), dropped nucleus (3%), suprachoroidal hemorrhage (0.3%), and retrobulbar hemorrhage (0.3%).41 eyes (15%) had documented PXF preoperatively. Eyes with PXF were more likely to result in poor dilation (p = 0.004), zonular abnormalities (p < 0.001), and vitreous loss (p = 0.04). The location of IOL placement in eyes with PXF was significantly different (p = 0.003), specifically that more anterior chamber intraocular lenses were placed in eyes with PXF (p < 0.001). Eyes with PXF also were more likely to have elevated post-operative IOP (p = 0.09), however this did not reach statistical significance.
This study confirms our previously reported incidence of PXF in this Central American population of 15%. PXF is associated with increased likelihood of intraoperative and post-operative complications from cataract surgery. Detailed preoperative exam and preparation are warranted to anticipate such complications.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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