Pseudoexfoliation Syndrome: Clinical Profile and Visual Outcome after Manual Small Incision Cataract Surgery

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Authors

  • PG Resident, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nasik – 422003, Maharashtra ,IN
  • Senior Resident, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nasik – 422003, Maharashtra ,IN
  • Professor and Head, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College and Hospital, Research Centre, Nasik – 422003, Maharashtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2019/v6i2/22916

Keywords:

Complications, Pseudoexfoliation, SICS, Vitreous Loss, Zonular Dialysis
Cataract Surgery

Abstract

Background: Pseudoexfoliation (PXF) is an age related, systemic, elastic fibrillopathy causes serious complications during cataract surgery such as zonular dialysis, capsular rupture and vitreous loss. Aim: To study the profile of eyes with pseudoexfoliation syndrome and outcome after Manual Small Incision Cataract Surgery. Materials and Methods: This was a hospital based, prospective study was conducted at Tertiary Care Hospital between August 2016 to September 2018. PXF was diagnosed on slit lamp examination by the presence of white dandruff like material in anterior segment. Gonioscopy was done to know the status of angles, pigmentation and presence of PXF material. Results: Out of 80 patients with PXF who underwent manual small incision cataract surgery (MSICS), 17 patients had complications. Zonular Dialysis alone was found in 3 eyes (17.65%) and Zonular Dialysis with Vitreous Loss was seen in 4 eyes (23.53%). Only Posterior Capsular Rent (PCR) was found in 2 eyes (11.76%) and PCR with Vitreous Loss was found in 4 eyes (23.53%). Sphincter Tear was noted in 3 eyes (17.65%) and Iridodialysis was seen in one eye (5.88%). Conclusions: Ophthalmologists should focus on the detection of PXF especially considering the risks for intraoperative complications related to PXF. The diagnosis of PXF may also be important in the management of cataract in these patients.

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Published

2020-05-07

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Original Research Article

 

References

Lee B, Samuelson S. Glaucoma associated with pseudoexfoliation Syndrome. In: Yanoff M, Duker J, eds.

Ophthalmology. 4th ed. Elsevier Saunders; 2014:1070–2.

Tarkkanen A, Kivela T. John G. Lindberg and the discovery of exfoliation syndrome. Acta Ophthalmol

Scand. 2002; 80:151–4. https://doi.org/10.1034/j.16000420.2002.800206.x.PMid:11952480

Vijayalakshmi V, Desai S, Prasanna N, Sreelakshmi G. pseudoexfoliation syndrome: Prevalence in South Indian population. International Journal of Medical Science and Clinical Inventions. 2015; 2(03):766–71.

Drolsum L, Ringvold A, Nicolaissen B. Cataract and glaucoma surgery in pseudoexfoliation syndrome: A review. Acta Ophthalmologica. 2007 Dec. https://doi.org/10.1111/j.1600-0420.2007.00903.x. PMid:17376188

Plateroti P, Plateroti AM, Abdolrahimzadeh S, Scuderi G. pseudoexfoliation syndrome and pseudoexfoliation glaucoma: A review of the literature with updates on surgical management. J Ophthalmol. 2015; 2015:370–1. https://doi.org/10.1155/2015/370371. PMid:26605078 PMCid:PMC4641922

Sit A, Johnson D. The exfoliation syndrome: A continuing challenge. In. Albert D, Miller J, editors. Albert and Jackobiec's Prinicples and Practice of Ophthalmology. 3rd ed. Elsevier Saunders; 2008. p. 2581–93. https://doi.org/10.1016/B978-1-4160-0016-7.50206-X

Gupta CN, Pottur P, Spoorthi. Clinical profile of pseudoexfoliation in cataract surgery-a cross sectional study. TJPRC: International Journal of Ophthalmic Surgery and Ocular Pharmacology. 2016 Dec; 1(2):13–22.

Islam MN, Goswami S (Gayen), Khanam BSM, Mukherji S. Complications of Cataract Surgery in Patients with pseudoexfoliation syndrome in a Tertiary Care Hospital of West Bengal. Int J Sci Stud 2017;5(3):11-15.

Kaygisiz M, Elgin U, Tekin K, Sen E, Yilmazbas P. Comparison of anterior segment parameters in patients with pseudoexfoliation glaucoma, patients with pseudoexfoliation syndrome, and normal subjects. Arquivos Brasileiros de Oftalmologia. 2018 Apr; 81(2):110–15.https://doi.org/10.5935/0004-2749.20180025. PMid:29846427

Young AL, Tang WWT, Lam DSC. The prevalence of pseudoexfoliation syndrome in Chinese people. Br J Ophthalmol. 2004; 88:193–5. https://doi.org/10.1136/ bjo.2003.021816. PMid:14736771 PMCid:PMC1772018

Bairy SN, Praveen P, Kemidi. Prevalence of ocular pseudoexfoliative syndrome in rural population: A study from South India. Indian Journal of Clinical and Experimental Ophthalmology. 2016 Jul-Sep; 2(3):231–7. https://doi.org/10.5958/2395-1451.2016.00050.0

Ramalakshmi B, Ramachandraiah G, SiddaNaik B, Padma S. A clinical study of complications and visual outcome of cataract surgery in patients with pseudoexfoliation. IOSR Journal of Dental and Medical Sciences. 2018; 17(3):54–8.

Arvind H, Raju P, Paul PG, Baskaran M, Ve Ramesh S, George RJ, et al. pseudoexfoliation in South India. Br J Ophthalmol. 2003; 87(11):1321–3. https://doi.org/10.1136/bjo.87.11.1321. PMid:14609823 PMCid: PMC1771878

Nagrale P, Kesharaju V, Nandan N, Reddy K, et al. A study of eyes with pseudoexfoliation, its association with cataract and its implications in cataract surgery. International Journal of Contemporary Medical Research. 2018; 5(9):1– I5. https://doi.org/10.21276/ijcmr.2018.5.9.29

Madhavi C, Latha YJS, Pyaraka D, Kumar MA. A study on the visual outcomes and complications of cataract surgery in the rural population of Indian patients with pseudoexfoliation. Indian Journal of Clinical and Experimental Ophthalmology. 2015; 1(3):168–74. https://doi.org/10.5958/2395-1451.2015.00009.8

Thomas R, Nirmalan PK, Krishnaiah S. pseudoexfoliation in Southern India: The Andhra Pradesh eye disease study. Invest Ophthalmol Vis Sci. 2005; 46:1170–6. https://doi.org/10.1167/iovs.04-1062. PMid:15790875

Rao A, Padhy D, Sahay P, Pradhan A, Sarangi S, Das G, et al. Clinical spectrum of pseudoexfoliation syndrome - An electronic records audit. PLOS One. 2017; 12(10). https://doi.org/10.1371/journal.pone.0185373. PMid:29077713 PMCid:PMC5659605

K. Satish, D. N. Prakash, NiratiSrivastava, AmbikaAcharya, RaheelaAfshan, Serine Johnson, Amudha A, AyletteDsilva. Management of Intraoperative Complications and Visual Outcome in Patients having Cataract with pseudoexfoliation Syndrome. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 38, August 25; Page: 9829-9836, DOI: 10.14260/jemds/2014/3273

Bangal S, Bhandari A, Gogri P. Outcome of cataract surgery in patients with pseudoexfoliation. DJO. 2013; 23:183–6. https://doi.org/10.7869/djo.2012.66

Jawad M, Nadeem AU, Khan Au, Aftab M. Complications of cataract surgery in patients with pseudoexfoliation syndrome. J Ayub Med Coll Abbottabad. 2009; 21:33–6.

Kuchle M, Viestenz A, Martus P, Handel A, Junemann A, Naumann GOH. Anterior chamber depth and complications during cataract surgery in eyes with pseudoexfoliation syndrome. Am J Ophthalmol. 2000; 129:281–85. https:// doi.org/10.1016/S0002-9394(99)00365-7

Erkayhan GE, Dogan S. Cataract surgery and possible complications in patients with pseudoexfoliation syndrome. Eurasian J Med. 2016; 49(1):22–5. https://doi.org/10.5152/eurasianjmed.2016.0060. PMid:28416927 PMCid:PMC5389488

Freyler H, Radax U. Pseudoexfoliation syndrome: A risk factor in modern cataract surgery? Klin Monatsbl Aungenheilkd. 1994; 205:275–9. https://doi.org/10.1055/s-2008-1045528. PMid:7844941