Complications of Cataract Surgery in Patients with Pseudoexfoliation Syndrome in a Tertiary Care Hospital of West Bengal
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 3
Abstract
Introduction: The pseudoexfoliation (PEX) syndrome is a production and deposition of fibrillar extracellular material in ocular structure. The prevalence of PEX based on hospital reports from India varies between 1.87% and 13.5%. Aim: To study the prevalence of PEX, and complications during cataract surgery due to the pupillary rigidity and zonular weakness and instability as well as post-operative complications. The purpose of this study was to assess the frequency and types of complications of small incision cataract surgery (SICS) in patients with cataract and PEX. Materials and Methods: A cross-sectional descriptive study was conducted on 3334 eyes of 512 patients with cataract and PEX who underwent SICS in a tertiary care hospital from 1st July 2013 to 31st December 2016. The PEX was diagnosed by the presence of gray flakes on the anterior lens capsule or at the pupillary margin or both. Results: Prevalence of PEX was 15.53% (512 cases). 358 (69.92%) patients were male, and 154 (30.07%) cases were female. There was tendency of increasing prevalence of PEX with advancement of age, 4 (1.24%) in 41-50 years, 51 (9.96%) in 51-60 years, 162 (31.45%) in 71-80 years, 213 (41.11%) in 71-80 years, and 88 (16.98%) were >80 years of age group. Poor pupillary dilatation in spite of the use of standard mydriatic drops and nonsteroidal anti-inflammatory drugs was the most common finding in 334 (65.32%) cases. In 62 (12.10%) cases, a supplementary procedure of pupillotomy was done. Other problems encountered were accidental iridodialysis in 6 (1.17%), zonular dialysis in 7 (1.36%) posterior capsule rupture with vitreous loss in 14 (2.73%), retained cortical matter in 44 (8.59%), and decentered intraocular lens 23 (4.49%) cases. Conclusion: Presence of associated PEX in cataract patients significantly increases the risk of vision-threatening complications. Use of flexible iris hooks for small pupils and capsular stability are advocated, capsular tension rings and high viscosity viscoelastics are useful modifications of surgical technique for good visual outcome.
Authors and Affiliations
M Nazarul Islam, Sharmistha Goswami (Gayen), Begum Sabiha Mashuda Khanam, Sushmita Mukherji
Keywords
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