Phacoemulsification in Indian eyes with pseudoexfoliation syndrome

Purpose: To evaluate the intraoperative and postoperative behavior after ph acoemulsification in Indian eyes with pseudoexfoliation syndrome. Setting: IIadevi Cataract & Intraocular Lens Research Centre, Ahmedabad, In dia. Method: Ninety eyes were prospectively evaluated. Group 1 (cohort) comprise d 45 consecutive eyes with pseudoexfoliation and coexisting cataract and Gr oup 2 (control), 45 consecutive normal eyes with senile cataract only, Phac oemulsification was performed by a single surgeon using a step-by-step, cho p in situ, and lateral separation technique. An AcrySof (R) intraocular len s was implanted in the bag in all eyes, Intraoperative observations include d pupil size after maximal mydriasis, phakodonesis, zonular dehiscence, gra de of cataract, and capsule tear/rupture. Postoperatively, intraocular pres sure (IOP), best corrected visual acuity, aqueous flare/cell response, and the presence of posterior synechias were evaluated at 1 day and 1 month. A. chi-square test was used for statistical analyses. Results: The mean pupil size was significantly smaller in Group 1 (P = .000 0). No eye in either group had phakodonesis. Sixty percent of eyes in Group 1 and 31 % in Group 2 had a hard cataract (P = .008). Endocapsular phacoem ulsification was performed in 82% of eyes in Group 1 and 84% of eyes in Gro up 2. Intraoperative complications such as zonular or capsular dehiscence w ere not seen in any eye. Postoperatively, IOP and aqueous cell response wer e comparable between groups (P = .11 and P = 0.81, respectively). A signifi cantly higher flare response was observed in Group 1 (P = .000). The visual outcome at 1 month was similar between groups. Conclusions. The intraoperative performance of Indian eyes with pseudoexfol iation was comparable to that in normal eyes. A good Surgical outcome is en sured by using an appropriate surgical technique. Apart from a higher flare response, the postoperative outcomes in eyes with pseudoexfoliation were w ithin normal limits, and the outcome at 1 month was satisfactory. (C) 2001 ASCRS and ESCRS.