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J Cataract Refract Surg. 2010 Aug;36(8):1261-9. doi: 10.1016/j.jcrs.2010.02.014.

Pseudoexfoliation: High risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification.

Author information

1
Center for Eye Research and Education, Boston, Massachusetts 02114, USA. bjshingleton@eyeboston.com

Abstract

PURPOSE:

To assess the frequency and results of cataract surgery with concurrent vitrectomy due to zonule weakness in eyes with pseudoexfoliation (PXF).

SETTING:

Private practice, Boston, Massachusetts, USA.

METHODS:

This retrospective nonrandomized study assessed consecutive eyes with PXF having cataract surgery. High risk was defined as preoperative phacodonesis, iridodonesis, or lens subluxation (subgroup 1); preoperative anterior chamber depth or angle-depth asymmetry between eyes confirmed by slitlamp biomicroscopy or gonioscopy, respectively (subgroup 2); or complicated cataract extraction related to zonule weakness in the fellow eye (subgroup 3). Exclusion criteria were previous vitrectomy, scleral buckle, or trabeculectomy surgery and combined cataract-glaucoma surgery. A comparative analysis of outcome parameters was performed.

RESULTS:

Of the 1059 eyes evaluated, 38 had vitrectomy. Concurrent vitrectomy was required in 19 (15.6%) of 122 high-risk eyes and 19 (2.0%) of 937 non-high-risk eyes (P<.00001). The need for concurrent vitrectomy was greatest in subgroup 3 (72.7%) and subgroup 1 (42.9%). There was no statistically significant difference between the vitrectomy group and the no-vitrectomy group in the mean improvement in logMAR corrected distance visual acuity (CDVA) (P = .38) or mean change in intraocular pressure (IOP) (mean decrease 2.6 mm Hg +/- 1.5 [SD] and 1.6 +/- 0.5 mm Hg, respectively) (P = .47).

CONCLUSION:

Despite the need for vitrectomy and the attendant increased demands in postoperative care, both the vitrectomy group and no-vitrectomy group had improved logMAR CDVA and IOP.

FINANCIAL DISCLOSURE:

No author has a financial or proprietary interest in any material or method mentioned.

PMID:
20656147
DOI:
10.1016/j.jcrs.2010.02.014
[Indexed for MEDLINE]

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