STUDY ON INTRAOPERATIVE COMPLICATIONS OF CATARACT SURGERY IN PATIENTS WITH PSEUDOEXFOLIATION

Abstract

Background and objective: Pseudoexfoliation syndrome is an age related systemic microbrillopathy that involves eyes through gradual deposition of abnormal brillar extracellular material in ocular tissues. The pseudoexfoliative material is deposited on the corneal endothelium, trabecular meshwork, angle structures, iris, pupillary margins, ciliary processes, zonules, anterior lens capsule, and anterior hyaloid phase. Pseudoexfoliation syndrome is associated with an increased incidence of nuclear cataracts. This study is done to analyse the intraoperative complications of cataract surgery in patients with pseudoexfoliation. Materials and methods: It is an observational study conducted in the department of Ophthalmology in a tertiary care hospital from January 2021 to December 2022. A total of 78 eyes of 78 patients aged more than 40 years diagnosed with cataract and associated with pseudoexfoliation were included in the study. After assessing best corrected visual acuity (BCVA), detailed anterior and posterior segment evaluation was done along with keratometry, contact A-scan biometry. Intraocular lens (IOL) power was calculated. All patients underwent small incision cataract surgery (SICS) under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were reported. BCVA was recorded on day 1, 1st week and 6th week. Results: Out of 78 eyes of 78 patients, 42(53.8%) were males and remaining i.e. 36(46.2%) were females. Out of these 61.5 % had bilateral involvement. The intraoperative difculties observed during cataract cataract surgery was poor pupillary dilation, which was seen in 41% patients. The intraoperative complications like rhexis extension, posterior capsular rent, zonular dialysis, vitreous loss were noted. The BCVA of 6/12 and more was noted in 80.8% patients on post op 6th week. Conclusion: Inadequate mydriasis is one of the major preoperative risk factors in patients with Pseudoexfoliation syndrome which in turn result in the intraoperative complications. Although Cataract surgery in patients with pseudoexfoliation is challenging, if the surgeon is aware of the condition pre-operatively and pays meticulous attention to the surgical technique, the intraoperative complications can be managed and a good outcome can be expected.