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M. Streho, C. Rohart, B. Guigui, F. Fajnkuchen, G. Chaine; Pseudo-Exfoliation Syndrome in Cataract Surgery Retrospective Study of 37 Cases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):386.
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To analyze the clinical features of pseudoexfoliation syndrome (PEX) and to determine complications in cataract surgery in eyes with PEX compared with eyes with no PEX.
A retrospective, single-centre and comparative study was conducted on patients who underwent cataract surgery over a period of 18 months (between oct 2004 and march 2006). 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 pseudoexfoliation syndrome (PEX).
Seventy-four eyes operated of cataract were included in the study. The eyes were divided into two groups : the first group (n=37) with PEX, and the second group (n=37) with no PEX (control group). PEX was unilateral in 21 cases (61%). Open-angle glaucoma was associated in 11 cases (32%) in the PEX group versus 2 cases in the control group (5.4%). Poor pupil dilatation was observed in 8 cases (24%) in the PEX group and in 1 case (2.7%) in the control group. Phacoemulsification with posterior chamber intraocular lens (IOL) was the surgical technique in all the cases with only 1 case (2.7%) of anterior chamber IOL in the PEX group. There was no significant difference in the surgical complications and in the pre- and the postoperative intraocular pressure between the two groups (p>0.05). The mean preoperative visual acuity was 20/200 in the PEX group and 20/100 in the control group. There was a statistical difference between the two groups in preoperative visual acuity (p<0.05). The mean postoperative visual acuity was 20/50 in the PEX group and 20/32 in the control group. There was a statistical difference between the two groups in postoperative visual acuity (p<0.05). The moderate visual improvement in the PEX group was explained by the occurrence of severe open-angle glaucoma in this group.
PEX is the most common in its unilateral presentation. It is frequently associated with open angle glaucoma. Poor pupil dilatation is one of the most common problems faced by cataract surgeons. Nevertheless pseudoexfoliation syndrome did not confer a statistically higher risk for surgical complication in eyes without marked phacodonesis or lens subluxation.
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