Anand Eye Hospital Clear Vision Centre, Trivandrum, Kerala, India.
Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India.
Int Ophthalmol. 2022 May;42(5):1447-1455. doi: 10.1007/s10792-021-02134-z. Epub 2021 Nov 28.
The aim of the study was to assess the spectrum of clinical presentation, intraoperative challenges and immediate surgical outcome of cataract patients with pseudoexfoliation syndrome (PXF) following manual small incision cataract surgery (MSICS).
This prospective observational study which was conducted in a rural tertiary care hospital included adult patients with cataract and associated PXF. MSICS was performed for all after a complete ophthalmic and systemic examination. Clinical profile, intraoperative and post-operative complications were noted. Uncorrected visual acuity on first day post-surgery was used to assess the surgical outcome following MSICS.
MSICS was performed in 80 eyes with varying grades of cataract and PXF. The mean age of the patients was 62.5 ± 8.9 years. PXF material on pupillary margin in 77(96%) patients was the most common finding noted. Majority of the patients had advanced cataract (72, 90%) and inadequate mydriasis (62, 77.5%). Posterior capsular rent (8, 10%) and zonular dehiscence (8, 10%) were the intraoperative difficulties faced. Uncorrected visual outcome on first post-operative day was moderate to good in 71 (88.8%) patients, limited by post-operative corneal oedema (21, 26.3%), iritis (31, 38.8%) and aphakia (9, 11.3%).
Patients with pseudoexfoliation had poor pupillary dilatation, advanced cataracts and higher rate of posterior capsular rent. Our study showed good outcome of MSICS in PXF patients, even with advanced cataract suggesting that MSICS is a safe, effective and viable option for patients with PXF and cataract.
本研究旨在评估白内障合并假性剥脱综合征（PXF）患者行手法小切口白内障手术（MSICS）的临床表现、术中挑战和即刻手术结果。
这是一项在农村三级保健医院进行的前瞻性观察研究，纳入了伴有白内障和 PXF 的成年患者。所有患者均在进行全面眼科和全身检查后接受 MSICS。记录临床特征、术中及术后并发症。术后第一天未矫正视力用于评估 MSICS 后的手术结果。
共 80 只眼接受了不同程度白内障和 PXF 的 MSICS。患者的平均年龄为 62.5±8.9 岁。77 例（96%）患者的瞳孔缘有 PXF 物质，这是最常见的发现。大多数患者有进展期白内障（72 例，90%）和不充分的散瞳（62 例，77.5%）。术中遇到的困难主要有后囊膜撕裂（8 例，10%）和悬韧带断裂（8 例，10%）。术后第一天未矫正视力为中等到良好的有 71 例（88.8%），受限于术后角膜水肿（21 例，26.3%）、虹膜炎（31 例，38.8%）和无晶状体（9 例，11.3%）。
假性剥脱患者的瞳孔扩张不良、白内障程度较重、后囊膜撕裂的发生率较高。我们的研究表明，MSICS 治疗 PXF 患者的效果良好，即使是进展期白内障患者也是如此，这表明 MSICS 是 PXF 合并白内障患者安全、有效且可行的选择。
