Cataract surgery and lens implantation in eyes with exfoliation syndrome

Objective: To evaluate the surgical technique, intraoperative complications, and outcomes of extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation in patients with exfoliation syndrome. Setting: Department of Ophthalmology, Hippokration Thessaloniki General Hospital, Thessaloniki, Greece. Methods: This prospective study comprised 84 patients with exfoliation syndrome who had ECCE and posterior chamber IOL implantation between December 1992 and November 1993. Main outcome measures were poor mydriasis, zonular rupture, vitreous loss, and best corrected visual acuity. Mean follow-up was 9.32 months (range 4 to 16 months). Results: Pupil diameter was smaller than 5.0 mm in 61.90% of the eyes. Zonular rupture, capsular tear, and vitreous loss occurred in 13.09, 10.71, and 7.14%, respectively. Best corrected visual acuity ranged from 7/10 to 10/10 in 72 eyes (85.71%). Conclusion: Patients with exfoliation who had ECCE and posterior chamber IOL implantation had an increased risk of intraoperative complications. In these patients, surgery must be done by experienced surgeons able to handle all possible complications.