Prevalence of Exfoliative Syndrome in Patients Scheduled for Cataract Surgery: A Review of 110 Cases

Abstract

Background: Capsular pseudoexfoliation syndrome (CEP) is an age-related systemic disorder of unknown etiology defined by the abnormal production and deposition of pseudoexfoliative fibrillar material both in the anterior segment and in several extraocular tissues [1, 2]. CEP is associated with the development of glaucoma, cataract and zonular instability. It is also responsible for specific surgical complications. Hence the interest to evaluate the prevalence of exfoliative syndrome in patients scheduled for cataract surgery and to shed light on its clinical and surgical particularities. Patients and methods: This is a retrospective, descriptive study involving 110 patients, admitted for cataract surgery, in the adult ophthalmology department, Hospital 20 August in Casablanca, from January 1, 2021 to January 2022. Patients underwent extraction by phacoemulsification or manual extraction with placement of an intraocular implant. Results: This study included 110 patients. The mean age was 66.67 years with a slight predominance of the female gender at 56% versus 44%. The percentage of PEC increases with age. Mean intraocular pressure was significantly higher in eyes with PES than in those without PES. The presence of PES increases the risk of intraoperative and postoperative complications, regardless of the surgical technique, regarding zonular rupture and vitreous exit. Conclusion: The exfoliative syndrome remains a frequent pathology in elderly subjects with cataracts, whose prevalence increases significantly over the age of 60. Its presence constitutes an important risk factor for primary open-angle glaucoma and increases the risk of intraoperative complications during cataract surgery, regardless of the technique used. The key points in surgery are the surgeon's experience and good dilatation.