A STUDY OF VISUAL OUTCOME OF CATARACT SURGERY IN PSEUDO EXFOLIATION AND TO EVALUATE ITS INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS IN TERTIARY HEALTH CARE HOSPITAL

Dr. Shrusti Chelawat; Dr. Harpal Singh; Dr. Kanchan Singh; Dr. Ashutosh Singhal; Dr. Pooja Chaudhary; Dr. Diksha Choudhary

Authors

Dr. Shrusti Chelawat Third Year Postgraduate Resident, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author
Dr. Harpal Singh Professor & HOD, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author
Dr. Kanchan Singh Associate Professor, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author
Dr. Ashutosh Singhal Third Year Postgraduate Resident, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author
Dr. Pooja Chaudhary Third Year Postgraduate Resident, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author
Dr. Diksha Choudhary Second Year Postgraduate Resident, Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. Author

Keywords:

Pseudoexfoliation Syndrome, Cataract Surgery, Visual Outcome, Zonular Dialysis, Posterior Capsule Rupture, Intraoperative Complications, Post-Operative Complications.

Abstract

Background: Pseudo-exfoliation is an age-related systemic disorder characterized by deposition of abnormal fibrillar material on ocular tissues, leading to poor pupillary dilatation, zonular weakness, and increased risk of complications during cataract surgery. Cataract extraction in PXF eyes is therefore considered surgically challenging. The present study was undertaken to evaluate the visual outcome of cataract surgery in patients with pseudoexfoliation and to analyze associated intraoperative and postoperative complications. Methods: This hospital-based observational study was conducted in the Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal, over 18 months. A total of 58 patients aged ≥50 years with senile cataract associated with pseudoexfoliation were included. Detailed preoperative evaluation included BCVA (Best-Corrected Visual Acuity), intraocular pressure measurement, gonioscopy, slit-lamp examination, and cataract grading. All patients underwent SICS (Small Incision Cataract Surgery). Patients were followed postoperatively on day 1, day 3, and at 1 month for visual outcomes and complications. Results: The mean age of patients was 68.16 ± 11.70 years, with slight male predominance (51.72%). Poor pupillary dilatation was observed in 36.21% of cases. Intraoperative complications included zonular dialysis (6.8%), posterior capsule rupture (5.1%), vitreous loss (3.4%), and aphakia (1.7%). Early postoperative complications included corneal edema (32.76%), iritis (32.76%), raised intraocular pressure (24.14%), hyphema (8.62%), retained lens matter (5.17%), and IOL decentration (6.90%). At 1 month postoperatively, 91.38% of eyes achieved visual acuity between 6/6 and 6/12. Zonular dialysis showed a significant association with posterior capsule rupture (p < 0.0001). Conclusion: Pseudoexfoliation significantly increases the complexity of cataract surgery because of poor mydriasis and zonular instability. Careful preoperative evaluation, meticulous surgical technique, and appropriate postoperative management can achieve satisfactory visual outcomes, despite higher intraoperative and postoperative complication rates.