PREVALENCE AND SURGICAL COMPLICATIONS OF PSEUDOEXFOLIATION SYNDROME IN PORTUGUESE PATIENTS WITH SENILE CATARACT

Purpose: To determine the prevalence and surgical complications of pse udoexfoliation syndrome (PES) in a Portuguese population of patients w ith senile cataract. Setting: Department of Ophthalmology, Coimbra Uni versity Hospitals, Coimbra, Portugal. Methods: in a prospective study, 183 consecutive patients with senile cataract referred to the Implant and Refractive Surgery Section of the Department of Ophthalmology wer e examined for PES. To determine the occurrence of intraoperative and postoperative complications of extracapsular cataract extraction with posterior chamber intraocular lens implantation in patients with PES, two groups of similar age were compared: one with PES (n = 31) and a c ontrol group without PES (n = 31). Results: The prevalence of PES in t he 183 Portuguese patients with senile cataract was 23.5%. There was a statistically significant difference between the two groups in the pr esence of phacodonesis (P < .05), insufficient intraoperative mydriasi s (P < .001), need to perform sphincterotomies to facilitate nucleus e xpression (P <. 01), and formation of pupillary fibrin membranes in th e postoperative period (P < .01). These complications were more freque nt in the PES group. Zonular breaks also occurred more often in patien ts with PES, although this was not statistically significant. Conclusi ons: Pseudoexfoliation syndrome was a common condition in patients wit h senile cataract having surgery in Portugal. Inadequate mydriasis was the major intraoperative difficulty; a pupil enlargement procedure sh ould be performed in these cases. In the first days postoperatively, t herapy with topical, subconjunctival, and systemic corticosteroids is recommended to reduce the inflammatory reaction in the anterior chambe r.