Intraoperative complications of phacoemulsification in eyes with and without pseudoexfoliation.

Department of Ophthalmology, Carmel Medical Centre, Haifa, Israel.
Journal of Cataract and Refractive Surgery (Impact Factor: 2.53). 06/2005; 31(5):1002-5. DOI: 10.1016/j.jcrs.2004.09.051
Source: PubMed

ABSTRACT To determine the intraoperative complications in a large series of phacoemulsification procedures, including patients with and without pseudoexfoliation, excluding those with marked phacodonesis or lens subluxation.
Department of Ophthalmology, Carmel Medical Centre, Haifa, Israel.
This institutional case-control study included 1501 consecutive phacoemulsification procedures: 137 eyes with pseudoexfoliation and 1364 eyes without this condition. Baseline demographics and clinical factors were collected from the medical files. A comparative analysis of the incidence of intraoperative complications in eyes with or without pseudoexfoliation was calculated. Univariate analysis and multiple logistic regression were used to identify ocular factors that predicted intraoperative complications.
There was no significant difference (P>.05) in the rate of intraoperative complications between the pseudoexfoliation (5.8%) and control (4.0%) groups. There were no significant differences in the incidence of capsular breaks, vitreous loss, and zonular ruptures without vitreous loss in the 2 groups. Pseudoexfoliation did not confer a statistically higher risk for intraoperative complications (odds ratio 1.62, 95% confidence interval 0.74-3.55).
Phacoemulsification by experienced surgeons is safe in eyes with pseudoexfoliation without marked phacodonesis or lens subluxation.

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    ABSTRACT: Purpose: To evaluate the incidence of pseudoexfoliation syndrome (XFS) in patients with senile cataract who were scheduled for phacoemulsification and intraocular lens implantation (PE + IOL) and to compare the outcomes of PE+IOL between eyes with and without XFS. Method: We retrospectively reviewed 2200 eyes with cataract undergoing PE + IOL. All procedures were performed by a single surgeon (M.A.J) at a private clinic. Patients with XFS were considered as the case group and age and sex matched patients without XFS were selected as controls. Results: The incidence of XFS was 4.1% (90 eyes). Mean age was 71.8±7.1 and 70.7±6.7 years in the case and control groups, respectively. XFS was unilateral in 60% of the cases. The prevalence of hypertension, diabetes mellitus (DM) and diabetic retinopathy (DR) was 31.1%, 6.7% and 0% in the XFS group vs 42.9%, 26.6% and 5.2% in the control group, respectively (P< 0.05). Glaucoma was present in 25.6% of the XFS group and 6.5% of the control group (P<0.0001). Vitreous loss occurred in one eye in each group; only one eye had zonular dehiscence in the XFS group. Iris stretching was performed during surgery in 11.1% in the XFS group and 1.9% in the control group (P<0.0001). Anterior capsule contraction occurred in 9.1% of the XFS group vs 0% in the control group (P= 0.007). Conclusion: PE + IOL in patients with XFS is as safe and effective as pure senile cataract. The incidence of DM and DR is significantly lower in XFS. • Bina J Ophthalmol 2006; 12 (1): 37-43.
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