A comparative study of intraoperative complications of pseudoexfoliation in manual small incision cataract surgery and phacoemulsification

Abstract

Background: Pseudoexfoliation Syndrome is an age related generalized disorder involving abnormal production or turnover of extra-cellular matrix in ocular tissues, orbital tissues, skin and visceral organs. Cataract is clouding of the lens in the eye commonly occurring due to increasing age, removed by surgery. Objectives 1. To compare the frequency and types of complications of small incision cataract surgery (SICS) and phacoemulsification surgery in patients with cataract with associated Pseudoexfoliation. 2. To determine the clinical outcome of the procedures. Materials and Methods: Study includes a sample of 100 patients diagnosed to have cataract with pseudoexfoliation, 50 of each undergoing either MSICS or Phacoemulsification, during the period of November 2017 to April 2019. Each case was examined clinically and an elaborative study of history based on chief complaints, significant risk factors, investigations, time and type of surgery performed and intraoperative and postoperative events were recorded. Following which management of these cases, based on facility available here was done. Results were analyzed by using SPSS 22.0 Version Software. Results: Difficult capsular rhexis was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Difficult nucleus delivery was encountered in 11 cases that underwent SICS and 4 cases that underwent Phacoemulsification. Zonular dialysis was encountered in 4 cases that underwent SICS and 11 cases that underwent Phacoemulsification. Difficult cortical aspiration was encountered in 19 cases that underwent SICS and 10 cases that underwent Phacoemulsification. Conclusion: Patients with pseudoexfoliation syndrome undergoing Manual Small Incision Cataract Surgery are at a higher risk for the development of intraoperative complications as compared to Phacoemulsification surgery. With appropriate preparation and use of specialized adjunctive devices, phacoemulsification is the preferred method of cataract extraction in eyes with pseudoexfoliation syndrome. The postoperative visual outcome was comparatively better in the patients that underwent Phacoemulsification than the patients that underwent Manual Small Incision Cataract Surgery.