Extracting cataracts in pseudoexfoliation cases as early as possible key to routine outcomes

SAN FRANCISCO — Small pupils, weak zonules and IOP spikes increase the difficulty of achieving successful cataract surgery results in pseudoexfoliation cases, and these difficulties can be exacerbated when surgeons wait to remove the cataract, an expert said.

Reay H. Brown, MD, presented pearls for performing cataract surgery in noncompromised pseudoexfoliation eyes at the joint meeting of the American Academy of Ophthalmology and the Pan-American Association of Ophthalmology.

"Perhaps the most important pearl is to remove the pseudoexfoliation cataract as early as possible," Dr. Brown said. "There are many advantages of early surgery — almost everything about a pseudoexfoliation patient and operation worsens with age and time."

As patients age, factors such as denser cataracts, weaker zonules and reduced dilation render pseudoexfoliation cataract removal more challenging to perform, he said.

Other pearls that Dr. Brown presented were the importance of frequent examination, careful planning and informed consent. He said appropriate surgical techniques for pseudoexfoliation risk factors are also important.