A Study of Difficulties and Complications Encountered in Patients with Pseudoexfoliation Syndrome Undergoing Manual Small Incision Cataract Surgery (MSICS)

Abstract

Pseudoexfoliation syndrome (PEX) is a systemic age-related disorder that is characterised by abnormal production of fibrillar extracellular matrix material and it's deposition in tissues of the eye and other systemic tissues. They are classically seen as deposits on the anterior lens capsule as dandruff-like white powdery residue. The material deposits in all anterior segment structures including iris, pupillary margins, ciliary body, corneal endothelium, zonules and anterior capsule of lens. In the eye, these deposits cause deviancy from normal structure and function, resulting in poor pupil dilatation, zonular weakness, changes in corneal endothelium, secondary glaucoma and nuclear cataract formation. These changes caused in the eye due to Pseudoexfoliation Syndrome can be a challenge for a surgeon doing routine cataract extraction and intraocular lens implantation in such patients, as these manifestations of PEX can prove to be obstacles during the surgery and cause post operative complications. The surgeon also has to keep in mind associated secondary glaucoma during management of such a case. Thus visual outcome could be compromised.