Prevalence and surgical complications of pseudoexfoliation syndrome in Portuguese patients with senile cataract

Purpose: To determine the prevalence and surgical complications of pseudoexfoliation syndrome (PES) in a Portuguese population of patients with senile cataract. Setting: Department of Ophthalmology, Coimbra University Hospitals, Coimbra, Portugal. Methods: in a prospective study, 183 consecutive patients with senile cataract referred to the Implant and Refractive Surgery Section of the Department of Ophthalmology were examined for PES. To determine the occurrence of intraoperative and postoperative complications of extracapsular cataract extraction with posterior chamber intraocular lens implantation in patients with PES, two groups of similar age were compared: one with PES (n = 31) and a control group without PES (n = 31). Results: The prevalence of PES in the 183 Portuguese patients with senile cataract was 23.5%. There was a statistically significant difference between the two groups in the presence of phacodonesis (P < .05), insufficient intraoperative mydriasis (P < .001), need to perform sphincterotomies to facilitate nucleus expression (P <. 01), and formation of pupillary fibrin membranes in the postoperative period (P < .01). These complications were more frequent in the PES group. Zonular breaks also occurred more often in patients with PES, although this was not statistically significant. Conclusions: Pseudoexfoliation syndrome was a common condition in patients with senile cataract having surgery in Portugal. Inadequate mydriasis was the major intraoperative difficulty; a pupil enlargement procedure should be performed in these cases. In the first days postoperatively, therapy with topical, subconjunctival, and systemic corticosteroids is recommended to reduce the inflammatory reaction in the anterior chamber.