Study of different intraoperative and postoperative complications during cataract surgery in eyes with pseudoexfoliation

Aims & objectives: 1) To study the different intraoperative & early postoperative complications during cataract surgery in eyes with pseudoexfoliation and to record the best corrected visual acuity at 8 wks postoperatively. Materials & methods: It is a single centre, prospective, observational study, cases of 50 cataract patients(50 eyes) with pseudoexfoliation that underwent Small incision cataract surgery at tertiary care hospital between November 2012 to October 2014 were included in this study, patients with history of exposure to intense infrared light, trauma, subluxated/dislocated lens without pseudoexfoliation, uveitis with posterior synechiae were excluded from this study. All SICS performed by the same surgeon. Patients age, sex, anterior segment evaluation with Slit lamp, fundus findings in both eyes, IOP measurement & presence of pseudoexfoliation material preoperative &on postoperative day 1 evaluated. Results: In this study PXF was noted in 38 % patients in the age group of 60-69 years.64% of the patients were males & 36% were females. Poor pupillary dilatation was noted in 28% patients ,moderate in 54% & good in 18% patients. in 14 patients with poor pupil dilatation ,85.71% patients had 1 or more intraoperative complications,& in 27 patients with moderate pupillary dilatation ,33.33% patients had intraoperative complications. Continuous curvilinear capsulorrhexis was done in 29 cases. In 15 eyes there was difficulty in completion of rrhexis, in 4 cases there was extension of the rrhexis and resultant pc rent. Postoperative iritis occurred in 34% patients, corneal oedema occured in 12 patients, of the total cases of corneal oedema, raised IOP was seen in 3 cases. Hyphaemaoccured in 1 patient, 8 patients had retained cortical material. Pigment dispersion on IOL were noted in 4 cases, Postoperative best corrected visual acuity at 8 weeks was 6/6-6/12 in 38% cases, 6/18 -6/36 in 50% and 6/60-CFCF in 12 %. Conclusion: surgeons should be aware of potential complications during cataract surgery in pxf eyes & adequate measures should be taken to prevent intraoperative complications, these include surgical modifications such as sphincterectomy & or bimanual pupil stretching, use of iris hooks in eyes with inadequate mydriasis.