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V. Sarda, C. Rohart, F. Fajnkuchen, S. Nghiem Buffet, M. Streho, G. Chaine; Pseudoexfoliation Syndrome and Phacoemulsification: Retrospective Study of 50 Cases. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1148.
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To determine the complications in cataract surgery by phacoemulsification in eyes with pseudoexfoliation syndrome (PEX) compared with eyes without this syndrome and to analyze the clinical features of pseudoexfoliation syndrome.
A retrospective, single-center and comparative study was conducted on patients who underwent cataract surgery between 2006 and 2008. Demographic parameters (age, sex, ethnicity, medical and ophthalmologic history), clinical features (visual acuity, pupil dilatation, intraocular pressure) before and after surgery and surgical complications have been analyzed and compared to a control group without PEX.
One hundred eyes of 90 patients were included in the study. The eyes were divided into two groups: 50 eyes with pseudoexfoliation syndrome (PEX) and 50 eyes without pseudoexfoliation (control group). There was no significant difference in the surgical complications between the pseudoexfoliation and control group (4%). The mean preoperative intraocular pressure was 16 ± 5 mmHg in the pseudoexfoliation group and 14 ± 3 mmHg in the control group. The mean postoperative intraocular pressure at 1 month was 14 ± 4 mmHg in the pseudoexfoliation group and 14 ± 3 mmHg in the control group. The mean preoperative and postoperative visual acuity are no statistically between two groups. The mean follow-up was 70 days in the pseudoexfoliation group and 30 days in the control group. Pseudoexfoliation was unilateral in 61% of cases. Open-angle glaucoma was associated in 11 cases (22%) in the pseudoexfoliation group versus 2 cases in the control group (4%). Poor pupil dilatation was observed in 8 cases (16%) in the pseudoexfoliation group and in 1 case (2%) in the control group. Phacoemulsification with IOL was the surgical technique in all the cases with only 1 case (2%) of anterior chamber IOL in the pseudoexfoliation group.
Poor pupil dilatation is one of the most common problems in cataract surgery in eyes with PEX. Nevertheless, the cataract surgery in eyes with PEX syndrome is not associated with a higher rate of surgery complications in our study. Pseudoexfoliation syndrome is most common in its unilateral presentation. It is frequently associated with chronic secondary open angle glaucoma. Coronary heart disease could occur more frequently in patients with PEX compared with subjects without PEX.
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