September 2016
Volume 57, Issue 12
ARVO Annual Meeting Abstract  |   September 2016
Aravind Pseudoexfoliation (XFS) Study (APEX): 3 year post operative results
Author Affiliations & Notes
  • Aravind Haripriya
    Cataract, Aravind Eye Hospital, Madurai, Tamilnadu, India
  • Chandrasekaran Shivakumar
    Cataract, Aravind Eye Hospital, Madurai, Tamilnadu, India
  • Madhu Shekhar
    Cataract, Aravind Eye Hospital, Madurai, Tamilnadu, India
  • Rengaraj Venkatesh
    Cataract, Aravind Eye Hospital, Madurai, Tamilnadu, India
  • Kalpana Narendran
    Cataract, Aravind Eye Hospital, Madurai, Tamilnadu, India
  • Alan L Robin
    Glaucoma, John hopkins university, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Aravind Haripriya, None; Chandrasekaran Shivakumar, None; Madhu Shekhar, None; Rengaraj Venkatesh, None; Kalpana Narendran, None; Alan Robin, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1987. doi:
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      Aravind Haripriya, Chandrasekaran Shivakumar, Madhu Shekhar, Rengaraj Venkatesh, Kalpana Narendran, Alan L Robin; Aravind Pseudoexfoliation (XFS) Study (APEX): 3 year post operative results. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1987.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : There are questions regarding both the intraoperative and long-term post-operative complications in eyes with pseudoexfoliation (XFS). Our study aims to evaluate the long term complications in XFS eyes who underwent phacoemulsification without prior clinical lens subluxation.

Methods : We prospectively randomized 1000 eyes with clinically graded XFS with or without glaucoma without preexisting phacodonesis into 4 groups: 3-piece Acrysof lenses (MA60AC) and single piece Acrysof lenses (SA60AT) with and without CTRs. We compared these to 500 eyes with cataracts alone randomized to receive either a SA60AT or MA60AC without CTR. All surgical and late postoperative complications were noted and analysed for each of 2 groups. Eyes were followed intraoperatively, at 1 day, 1, 3 and 6 months, 1, 2 and 3 years and will be followed up yearly for 10 years.

Results : We report the 3 year postoperative results of 857 XFS eyes and 447 controls. Mean IOP was 13.22(3.01) XFS & 13.27(2.93) Control, (p=0.783). There were no significant differences in IOL decentration (0.7 % vs. 0.67%, p=0.999), central posterior capsular opacification (4.5% vs. 6%, p=0.244), or new onset of glaucoma (1.1 % vs 2.1 %, p=0.081) between the two groups. There was no significant intergroup difference as well in the above variables. The three year, corrected distance VA > 6/9 was 98.02 % XFS compared to 98.2 % controls (p= 0.808). The overall mortality rate was 5.4 % (6 % vs 4%, p=0.161 ) with highest cardiac arrest / CVA accounting for 1.2 % (1.5 % vs 0.6%, p=0.299).

Conclusions : In eyes with mild XFS, there was no increased risk of complications at 3 years postoperative irrespective of IOL type or use of CTR. However longer follow-up will reveal if lens choice or the use of a CTR is related to significantly higher rate of late post op complications.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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